Endoscopic removal of an ingested pin migrated into the liver and affixed by its head to the duodenum

Abstract

Foreign body (FB) ingestion is a common condition in childhood. Most ingested FBs pass through the GI tract without any complication. Nevertheless, penetration of the intestinal tract is possible by sharp or pointed objects. Perforation may occur if such objects become lodged in a narrow segment of the GI tract. The morbidity depends on the continued route of the penetrating object and whether septic sequela ensue. 1 Although FBs may migrate to any intra-abdominal organ, perforation of the duodenum and migration into the liver are extremely rare. Only one case has been reported in the literature, in an adult woman. The pin was described in the liver, with the head of the pin in the lumen of the duodenum. In that case, the pin was removed laparoscopically. 2 Tothebestofourknowledge,wereportherethefirstpediatric case of an ingested pin that migrated from the duodenum into the liver. The pin was removed by flexible EGD by using a polypectomy snare, with the patient under general anesthesia. The patient tolerated the procedure well, without untoward effects.