Swallowed foreign bodies are common in the pediatric age group, but fortunately, the majority of them pass spontaneously without any adverse effects. Tube gastrostomy is an excellent method to provide prolonged enteral feeding. It is, however, associated with complications, namely, intraperitoneal leak and distal migration of the gastrostomy tube causing gastric outlet obstruction. This paper describes two unusual gastrointestinal foreign bodies, one was swallowed, while the other one was a complication of a tube gastrostomy.
Swallowed foreign bodies are a common problem in the pediatric age group. Fortunately, the majority of them traverse the gastrointestinal tract without any adverse effects [
A 5-year-old male, a known case of cerebral palsy, underwent Nissen's fundoplication and feeding gastrostomy. He presented to our hospital several months later, because the gastrostomy Foley's catheter was accidentally cut. The mother was concerned about the remaining portion of the Foley's catheter which was left behind. He was admitted to the hospital and underwent gastroscopy via the gastrostomy. This, however, revealed no foreign body in the stomach. The patient was asymptomatic, and so, he was discharged home hoping that the remaining portion of the Foley's catheter will pass spontaneously. On the same day in the evening, he was readmitted with bilious vomiting and abdominal distension. Plain abdominal X-ray erect and supine revealed dilated small bowel loops with multiple air-fluid levels with the Foley's catheter lying within the bowel loops (Figures
Plain supine and erect abdominal X-rays showing dilated small bowel loops with multiple air-fluid levels. Note the remaining portion of the Foley's catheter.
Intraoperative photographs showing the Foley's catheter with its balloon not deflated (a) and after it was deflated (b).
The Foley's catheter after it was removed. Note the punctured balloon.
A 10-year-old male child was admitted to the hospital with bile-stained vomiting and colicky abdominal pain of two-day duration. There was no history of previous surgery. Clinically, he was a normal-looking well-developed child with mild abdominal distension, mild diffuse tenderness and, active bowel sounds. Plain abdominal X-rays revealed few dilated small bowel loops with multiple air-fluid levels (Figures
Plain abdominal X-rays showing dilated loops with multiple air fluid levels.
Intraoperative photograph showing the pacifier inside the small intesines (a) and after it passed (b).
Clinical photograph showing the plastic bag removed from the stomach.
A large variety of foreign bodies are swallowed by children, but the majority, however, passes through the gastrointestinal tract without any adverse effects [
Tube gastrostomy is one of the common operations performed for prolonged enteral feeding especially in neurologically impaired children. It is, however, associated with complications. Two common complications of tube gastrostomy are intraperitoneal leak leading to peritonitis and distal migration of the gastrostomy tube producing gastric outlet obstruction [