Delayed presentation of foreign body ingestion in resource-limited setting managed with endoscopy: Case report and literature review

资源匮乏地区异物吞入延迟就诊的病例报告及文献综述:内镜治疗的病例分析

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Abstract

INTRODUCTION AND IMPORTANCE: Foreign body (FB) ingestion is a common pediatric gastrointestinal emergency, frequently involving coins, batteries, and magnets in children aged 6 months to 5 years, with boys affected more often. The 2021 poison control data reports ∼55,000 cases annually in children <5. CASE PRESENTATION: A 4-year-old girl presented to the pediatric emergency unit four months after ingesting a one Ethiopian birr coin. One week prior to her hospital presentation, she developed a dry cough, stridor, tachypnea, nausea, vomiting, and dysphagia. Evaluation revealed tachypnea, tachycardia, and oxygen desaturation to 87 % on room air. A chest X-ray showed a radio-opaque, circular foreign body at the T2-T3 level. The foreign body was successfully removed endoscopically, and the patient's condition improved after the procedure. CASE DISCUSSION: Foreign body ingestion is a frequent concern in pediatrics. The risk is elevated in children with congenital or acquired neuromuscular disorders and those with psychosocial risk factors. Clinical presentation varies, with most cases presenting acutely with respiratory or gastrointestinal symptoms, but delayed presentations can also occur. Effective management, including appropriate evaluation, endoscopic removal, and prevention strategies, is essential for optimizing patient outcomes. CONCLUSION: Foreign body ingestion, while typically presenting acutely, can have delayed presentations, especially in resource-limited settings, potentially leading to complications. Endoscopic management is often successful, underscoring the importance of considering foreign body ingestion in the differential diagnosis, even in cases with a long or unclear history, to ensure optimal patient outcomes.

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