Sarma Sanjeeb Kumar (Down Town Hospital/Guwahati/India), Prakritish Bora (International Hospital/Guwahati/India)  

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19 Days  

Female  

Neck-Pharynx  

physical  

A 29 days old female infant presented with history of drooling of saliva, excessive crying and mild respiratory distress for two days.  

A 29 days old female infant was brought to pediatric outpatient department with history of excessive drooling of salvia, crying and respiratory distress for 2 days. On examination the infant was having tachycardia and was tachypnaec also. Clinically chest, CVS, CNS and per abdominal examinations were normal. Chest x ray (antero-posterior view) revealed a metallic foreign body (a key) in the cervical region and superior mediastinum area confirmed the diagnosis of foreign body ingestion [Fig1]. General anesthesia was given. Direct laryngoscope revealed the tip (broad end) of the foreign body as silver color projection at the level of cricopharynx. Surrounding mucosa shows edema and oozing of blood. On touching the tip of the foreign body by the Mc Gill forcep, a metallic click feeling was observed by the pediatrician and by holding the tip the foreign body was removed. It measured approximately 3.4 cm x 0.9 cm and weighs 5 grams [Fig2].  

<- view X-Ray 1

X-Ray 1: Chest x ray (AP view) showing metallic foreign body (a key) in lower cervical and superior mediastinum area.





<- view OP-Situs 1

OP-Situs 1: Showing the foreign body (key) after removal.

 

Other  

N/A  

No complication followed after removal of the foreign body.  

Though children from 5 months to 6 years of age group present commonly in ENT department with foreign body ingestion, however neonatal foreign body ingestion is rare. It can be accidental like from the hands of parents, relatives or elder sibling. In this case the parents doubted the role of relatives for homicidal attempt. No police case was registered till discharge  

N/A  

1. Panda N. Management of sharp esophageal foreign bodies in young children: a cause for worry. International Journal of Pediatric Otorhinolaryngology, 2002, 64(3):243-246.

2. Tasneem Z, Khan M.A. M., Uddin N. Esophageal foreign body in Neonates. J Pak Med Assoc 2004 Mar; 54(3):159-61.

3. Poorey V. K., Dixit S. and Shakya R. Foreign body oesophagus in neonate with unusual presentation. 2008 June (60)2.

4. Medatwal A., Gupta P. P., Gulati R. K. Multiple Foreign Bodies in a Neonate. Indian pediatrics. 2008 Nov; (45) 17.  

Foreign body, neonate, esophageal, key, child, childhood, pediatric radiology  

Sarma Sanjeeb, Prakritish Bora. Key as unusual esophageal foreign body in neonate. PedRad [serial online] vol 9, no. 4.
URL: www.PedRad.info/?search=20090420160623