After Foreign Body Ingestion: Waiting is not Always Disastrous

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Background: Foreign bodies are objects with both organic and inorganic nature which originate from outside the human body. Due to ingestion, the gastrointestinal tract has become more prone mostly affecting paediatrics as compared to the adult population. Children with gastro-intestinal abnormalities including stenotic lesions and a history of Tracheoesophageal fistula are at increased risk of both occurrence and complications. The type, size, chemical properties of the object and the site of lodgment; all determine the clinical presentations. A history surrounding the circumstances, clinical presentations and radiological investigations are the pillars for diagnosis formulation. Besides the expectant and minimally invasive treatments, invasive modalities can also be employed especially in the presence of complications. Case presentation: A 3-year-old boy was brought to our hospital with a history of retching, hyper-salivation and inability to tolerate oral feeding as preceded by circumstances pointing towards gastrointestinal foreign body ingestion. An X-ray was suggestive of a gastrointestinal circular radio-opaque foreign body more likely at the level of duodenum in keeping with the coin. As he had no mechanical obstructive features, expectant management was done of which four days later he had a simultaneous passage of a 200 Tanzanian shilling’s coin on defecation. Conclusion: Early diagnosis, determining the surrounding circumstances and type of the foreign body ingested are the cornerstones for management modalities and outcomes. Both minimal and invasive approaches can be used, but the power of watchful waiting should not be underestimated as it can well be guided by the nature of the objects and the patient’s clinical presentations