Atypical Presentation of Multiple Foreign Body Ingestion - A
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Foreign body ingestion is very common in childhood especially under 3 year of age. Pica syndrome is characterized by an appetite for substances that are largely non-nutritive. We present a 3-year old girl who presented to ER with symptoms and signs of intestinal obstruction. She was admitted to emergency department with abdominal pain and vomiting for the last three hours. She had history of dysphagia for one month and contrast-swallow (performed a month before presentation) was found to be normal. On examination, she had abdominal distention and tenderness with no bowel sounds. Nasogastric intubation was performed. Abdominal x-ray showed a radio-opaque mass located below the liver . Ultrasonography suspected abscess formation (33mm x 27mm) on right side of the abdomen. On CT scan there was suspicion of perforation or possible abdominal mass filling right side of abdomen. Decision of surgery was thus taken. During intubation, a button of pant was found stuck in her nostrils. Bronchoscopy was performed for other possible foreign body and infectious mucus was aspirated from the main bronchi. On exploration, intestinal perforation was found with fecal content protruding through extensively dilated ileocecal region and a mass was seen arising from it. Resection of terminal ileum, cecum and ascending colon was performed; and ileostomy and colonic mucous fistula were made. Postoperative recovery was uneventful....

http://www.apspjcaserep.com/ojs/index.php/ajcr/article/view/525/388
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