21 Sep 2019, Pune : 7yr old Rahul (name changed) was brought to Columbia Asia Hospital Hebbal. While he was playing with pencil cap in the class by keeping it in mouth and taking air through it, he accidently swallowed the pen cap and started coughing. The teacher noticed the student coughing continuously and took him to medical room at the school. The teacher noticed some unusual sound while the kid was breathing. In the medical room the kid was normal and the nurse assumed that the kid was doing fine but the teacher was keen and insisted that the student must be taken to the hospital for further treatment.
The kid was rushed to the emergency unit of the hospital and a team lead by Dr. Mahesh Mylarappa, Consultant, Emergency Medicine, Columbia Asia Hospital Hebbal evaluated the kid and stabilised him. Child was then evaluated by Dr. Santosh Shivswamy, ENT Head and Neck Surgeon and he suggested a CT scan since in the X-ray the cap location couldn’t be traced due to it being transparent. Following detailed discussion by Dr. Santosh with radiologists Dr. Praveen the FB was identified. It was indeed a challenging case for the doctor, the radiologists and the anaesthesiologists. The scan also couldn’t detect the location of the foreign body easily. Dr. Praveen Wali, Consultant Radiologist was able to locate the cap body, which was stuck on the right side at the entry of the lung. Inducing anaesthesia was challenging as the child couldn’t be put on ventilator as this would lead to get the body stuck to the mucosa by Dr. Sushma and Dr. Uppin.
Post the surgery the pen cap was removed by Dr. Santosh without any complications. The child is doing fine now. Timely thought and persistence of the teacher was key to the diagnosis and the great skills of the surgeon and anaesthesiologist saved the child’s life.
Dr. Santosh, Consultant, ENT Head and Neck surgeon, Columbia Asia Hospital Hebbal, said “The ingestion of foreign bodies is most commonly a problem in young children. Objects commonly ingested by children include coins, small toys, pencils, pens and their tops, batteries, safety pins, needles and hairpins. The majority of ingested foreign bodies will pass safely through the gastrointinal tract and be passed with feces.”