Case report of a piece of dishwashing steel wool in a child’s pharynx

Parvin Abbaslou,Maryam Ahmadipour

doi:10.34172/jept.2020.09

Abstract

Objective: Foreign body swallowing is a common pediatric problem. A foreign body in the pharynx is a medical emergency that requires urgent intervention. Evaluation and treatment of pharyngeal foreign bodies is much more difficult in children than in adults and sometimes requires hospitalization and removal of the foreign bodies under general anesthesia due to children’s lack of cooperation. Fish and chicken bones are the most common swallowed foreign bodies, but an interesting case of a piece of dishwashing steel wool stuck in a child’s pharynx is reported in this article. Case Presentation: A 10-year old boy was presented with a history of dysphagia from five weeks ago. Oral examination did not reveal anything significant. In lateral neck radiographs of the patient, a metal wire was observed in the hypopharyngeal region opposite the 4th and 5th cervical vertebrae. Endoscopic attempts to remove the foreign body were not successful. Therefore, the foreign body was removed from the patient’s pharynx in the operating room under general anesthesia. No complications were observed. Conclusion: Despite the prevalence of swallowing foreign bodies in children, ingestion of a piece of dishwashing steel wool not diagnosed for three weeks was considered interesting to report. Pharyngeal foreign bodies are medical emergencies; therefore, it is particularly important to suspect the presence of a foreign body and perform diagnostic procedures.

Highlights

Foreign body ingestion happens at all ages, especially in children [1]
Pharyngeal foreign bodies are of particular importance due to their potential complications such as aspiration into the airways, infiltration into the surrounding soft tissues, perforation, inflammatory reaction and infections
Since the wire had penetrated into the pharyngeal soft tissue, it could not be observed in direct examination of the pharynx; an opaque object was seen in the posterior pharyngeal area on the lateral neck radiograph (Figure 1)

Summary

Introduction

Most foreign bodies pass through the gastrointestinal tract without any complications, but pharyngeal foreign body is a medical emergency [2,3]. Swallowing of unusual foreign bodies that has been observed in a limited number of cases can cause specific symptoms and complications and may require surgical intervention [6]. Endoscopic attempts to remove the foreign body were not successful due to inadequate vision and lack of cooperation from the child. He was transferred to the emergency room and the piece of wire was removed from the patient’s pharynx under general anesthesia based on Glide Scope guidance using forceps (Figure 2). The patient was discharged the day in good general conditions and without complications

Discussion

Conclusion