Abstract
IntroductionSmall smooth objects that enter the gut nearly always pass uneventfully through the gastrointestinal tract. Retention of foreign objects may occur due to congenital obstructive anomaly of the gut.Case presentationWe report here a child who presented with features of small gut obstruction which were attributed to a foreign body impacted in the intestine. At surgery, an annular pancreas was detected and the foreign body was found to be lodged in the distended proximal duodenum.ConclusionThe reported case highlights the fact that an impacted radio-opaque foreign body in a child should warn the pediatrician to the possibility of an obstructive congenital anomaly.
Highlights
Small smooth objects that enter the gut nearly always pass uneventfully through the gastrointestinal tract
The retention of foreign objects within the duodenum is suggestive of partial obstruction, usually of congenital origin [1,2,3]
We describe a child presenting with features of high intestinal obstruction where retention of such an object led to the discovery of congenital duodenal stenosis producing partial obstruction
Summary
Small round or oval objects that enter the stomach nearly always pass uneventfully through the gastrointestinal tract without requiring intervention. The symptoms seemed to commence after the child had swallowed a metallic pendant which was coin-shaped and about 12 mm in diameter; at the time of swallowing, the child was about 17 months old He underwent repeated plain upright radiographs of the abdomen to localize the foreign body and to determine whether it had been passed. Oval, or cuboidal foreign objects nearly always pass through the gastrointestinal tract promptly, and stasis of such objects in the stomach or duodenum is extremely uncommon [1] The retention of such foreign objects within the duodenum suggests partial obstruction, usually of congenital origin. PbuFopuliagpbdinuebyrlreienaqdsut1iighaondeg'r,raainpgnhtdtoalofftewhwerdaqbiluadtaoedmdraelonnto,sphtshoeowfpinsrmgestaehllnebcmoeweotefalalliinc'dtfoohuerbeliegfnt Plain radiograph of the abdomen showing the metallic foreign body in the right lower quadrant, the presence of a 'double bubble sign', and a few dilated loops of small bowel in the left upper quadrant. The third part of the duodenum was mobilized and duodenoduodenostomy was performed without dividing the pancreas
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