Large foreign body – pencil in the pelvic cavity of a girl two years

Abstract

Purpose . To inform doctors providing aid to children of the peculiar course of abnormal processes and clinical picture of cases when a big foreign body – a pencil – enters the small pelvis. Clinical observation : A 2-yearold girl was admitted to the emergency room of Kursk Regional Children’s Hospital No. 2. According to her mother, the girl was anxious, had abnormal rectal discharge and a subfebrile rise in temperature. Three days prior to the admission, the mother went to the bathroom, whereas the girl was drawing with pencils. Then the woman found a graze wound in the perineum, scanty hemorrhagic discharge and sought medical attention. The girl was examined by the duty gynecologist and an acute gynecological pathology was excluded. During the follow-up, the child remained anxious, abnormal defecation and rise in temperature were observed. An oblong, rod-shaped opaque foreign body 8 cm long and 0.3–0.4 cm in diameter was visible paravertebral and left to L v and in the small pelvis projection on plain abdominal radiography. An upper outline of an anechoic foreign body which is 60 mm long and 8.5 mm wide is visualized posteriorly to the urinary bladder and along the rectum and sigmoid colon during an abdominopelvic ultrasound. Conclusion . The article shows an examination plan and stages to be used in a child with a big foreign body in the free abdomen. It must be noted that an important criterion of successful treatment and management in this localization consists of well-coordinated work of pediatric surgical and gynecological services. Authors also state that detailed interrogation of parents is necessary (nutrition, defecation, behavior, etc.).