Online Exclusives
Curious foreign body in the bladder of an adolescent
We report the case of a 14 year old boy who presented at our emergency department because of increasing alguria and dysuria one year after inserting a wire cable into his bladder for autoerotic purposes. Endoscopic transurethral removal of the foreign body proved to be impossible because the cable was of a stiff consistency and was trapped in scar tissue at the bladder neck. The foreign body therefore had to be extracted using a Pfannenstiel approach. Urethrocystoscopy and uroflow performed one week later were normal.Colon perforation caused by a foreign body in Hirschsprung disease
Accidental ingestion of foreign bodies is a common emergency in the pediatric population. The foreign body generally passes through the whole gastrointestinal system spontaneously without causing an obstruction. This is the first case report in the literature of Hirschsprung disease associated with a radio-opaque foreign body lodged at the site of a perforated sigmoid colon. This case highlights the fact that, in the case of an impacted radio-opaque foreign body in a child, the possibility of an obstructive congenital anomaly should be kept in mind in the differential diagnosis.An unusual case of small bowel obstruction in a child caused by ingestion of water-storing gel beads
Foreign body ingestion occurs most commonly in the pediatric population. Small bowel obstruction is a rare complication that can occur, and surgical intervention is required. We present the first report of a case of an 18-month-old child with a jejunal obstruction caused by ingestion of water-storing gel beads used for botanical arrangements. The child presented with obstipation and nonbloody, nonbilious emesis. Symptoms resolved after a large bead 3 cm in diameter was retrieved via laparoscopic-assisted excision.Noningested intraperitoneal foreign body causing chronic abdominal pain: a role for laparoscopy in the diagnosis
In this article, we present an unusual case of a young boy who presented with abdominal pain and was found to have a sewing needle that had migrated through the abdominal wall into the peritoneal space. After imaging and endoscopy, the needle was extracted laparoscopically without any evidence of intra-abdominal organ injury and with a good long-term outcome for the child. There are no other such reported cases in the literature. This case highlights the subtleties in management of intra-abdominal foreign bodies in children including rare causes such noningested foreign bodies.Intestinal perforation caused by magnetic toys
Accidental ingestion of foreign bodies is a common problem in children, but ingestion of magnets is rare. When multiple magnets are ingested, they may attract each other through the intestinal walls, causing pressure necrosis, perforation, fistula formation, or intestinal obstruction; as has been reported in 13 cases in the past 10 years. We report the fifth case in the literature of intestinal perforation and fistula caused by the ingestion of 2 small magnetic pieces of a toy by a 3-year-old boy.A case report of severe tracheal obstruction requiring extracorporeal membrane oxygenation
The authors describe the case of a near-fatal airway obstruction requiring extracorporeal membrane oxygenation. The patient presented with severe respiratory distress owing to a bean impacted in the distal trachea. The foreign body could not be removed by bronchoscopy because of instability of the patient. The patient was placed on extracorporeal membrane oxygenation for temporary pulmonary support, and the foreign body was removed using a rigid bronchoscope. The patient had a full recovery and suffered no neurologic sequelae.Fibrobronchoscopic treatment of foreign body aspiration in children: an experience of 5 years in Hangzhou City, China
The aims of the study were to evaluate duration of symptoms, clinical manifestation, radiological findings, fibrobronchoscopic findings, and the complications of airway foreign body (FB).Pharyngo-esophageal reconstruction by free jejunal graft and microvascular anastomosis in a 10-year-old girl
Pharyngeal and upper esophagus substitution is an ordinary procedure in adults, performed mainly for oncologic purposes, but it is rarely done in children. The authors present a case report of a free jejunal graft pharyngo/esophageal reconstruction with microvascular anastomosis to the primitive carotid artery and the internal jugular vein in a a 10-year-old girl who had a loss of lower pharynx and cervical esophagus secondary to esophageal perforation by foreign body. Other surgical approaches for pharyngo-esophageal reconstruction in children are revisited.Severe bronchial synechia after removal of a long-standing bronchial foreign body: A case report to support control bronchoscopy
The authors report the case of a child who had severe bronchial synechia of the left main bronchus after removal of a pistachio shell embedded in granulation tissue. Histology finding of the removed granulation tissue at initial bronchoscopy showed an Actinomyces bacterial invasion. It was decided not to treat this local contamination and to perform a control bronchoscopy to verify the disappearance of local bacterial invasion. The control bonchoscopy performed 4 weeks after the foreign body (FB) removal disclosed a large central left main bronchus synechia producing a 70% reduction of the lumen, although the child had become asymptomatic except for a slight residual cough.
