Safe extraction of an impacted open safety pin from the esophagus: A case report

Abstract

Background: Children commonly experience a tendency to ingest foreign bodies. Open safety pins in the esophagus are quite uncommon, nevertheless. Peak rates of such ingestion range between 6 and 12 months. Case Presentation: A 9-month-old girl was admitted to the ED with a history of having swallowed a safety pin attached to her underwear 3 hours earlier, as witnessed by her mother. There were no symptoms present at the time of the assessment. Her blood tests and vital signs were both in the usual range. Plain radiographs of the neck, chest, and abdomen showed an open safety pin (SP) impinged in the upper third of the esophagus pointing upwards. While the infant was being intubated under general anesthesia, esophagoscopy was completed with a rigid pediatric esophagoscope. By grasping the SP by its tail end, a pair of crocodile forceps were used to reverse and straighten the pin in the esophagus such that its open end was pointed caudally. During surgery, a nasogastric tube was inserted. Ampicillin and neomycin were given intravenously for six days. On the fourth postoperative day observed the removal of the nasogastric tube. On the seventh postoperative day, the girl was allowed to go home. Recovery went without incident. Conclusion: For the removal of open safety pins, simple extraction methods, rigid and flexible endoscopies with the proper forceps, as well as surgery, can be used. Parents should also receive advice regarding the presence of safety pins around their children.