Conservative Management of Duodenal Perforation with Toothpick in a 9- Year Old Girl; a Case Report

Authors

1 Associate Professor of Pediatric Gastroenterology, Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.

2 Assistant Professor of Pediatric Surgery, Department of Surgery, Urmia University of Medical Sciences, Urmia, Iran.

Abstract

Background
Foreign body ingestion is a relatively common in children. Most ingested foreign bodies spontaneously pass out of the body via the gastrointestinal (GI) system but sharp materials may perforate the GI tract and need to surgical intervention.
Case Presentation
 The patient was a 9-year-old girl with progressive abdominal pain for one month and admitted with acute abdomen impression. She underwent esogastroduodenoscopy (EGD) due to severe epigastric tenderness. Upper GI endoscopy revealed duodenal ulceration and perforation by a toothpick while she had no history of foreign body ingestion. Toothpick was removed by endoscopy. She was successfully managed conservatively and had no abdominal pain during the one month follow-up period.
Conclusion
We recommend the endoscopic approach as the preferable method for the extraction of duodenal foreign bodies in children, even in the case of intestinal perforation.

Keywords