ENDOSCOPIC MANAGEMENT OF THE INGESTION OF PINS

Aims:

Ingestion of foreign bodies is a frequent emergency especially found in psychotics patients and children. Ingested objects can be dangerous because of their sharpness and their location in the digestive tract. The purpose of the work is to draw attention to the possibility of occurrence of such accidents.

Methods:

It is a retriospective study including all patients admitted to our unity for pin ingestion. Upper endoscopy and/or abdominal X-ray were performed in our patients.

Results:

Of the 53 cases of foreign body ingestion treated in the service, the pins represent 11.3% of cases (n = 6). All patients were female with an average age of 20 years [17 – 23]. The ingestion was accidental of a pin placed at the end of the lips. The emergency consultation time was less than 24 hours for 3 patients, 3 days for a patient and 12 days for 2 patients. The symptomatology corresponded to epigastralgia in 4 cases and a discomfort in swallowing in only one case whereas in a single case the patient was asymptomatic. The abdominal x-ray showed an intragastric seizure needle in 5 patients. Upper endoscopy, on the other hand, revealed an intragastric needle in 2 patients, a prepyloric needle in 2 patients and a pin attached to the mouth of the esophagus at the level of the piriform sinus in one patient. upper endoscopy leaded to the successful extraction of the needle in 4 patients, and abdominal radiological monitoring was decided in the other 2 patients: the needle was spontaneously removed in the stool.

Conclusions:

Unlike sharp foreign bodies, the extraction of fine pins endoscopically remains an innocuous and easy gesture when the pin is not embedded or adhered to the wall which can lead to surgical treatment.