A 4-year-old boy underwent surgery after doctors found that a hair pin he swallowed pierced his right kidney. In an online report for this case, the doctors emphasized the unusual complications that result from ingesting foreign objects.

Young children are prone to swallowing small objects like coins and bones. Experts said this is quite common especially in children who have just started learning how to pick up things with their hands. However, doctors said that these objects typically pass through the gastrointestinal tract and end up being excreted from the bowel.

In this case, a young boy presented to numerous medical centers with complaints of on-and-off fever and chills, pain in the right upper part of his abdomen and right side flank pain. The said symptoms have been present for three months upon consultation.

At first, the boy was diagnosed with urinary tract infection and was prescribed with antibiotics. After the drug therapy, the boy exhibited progress, but only to a very minimal extent.

The parents brought their child to another facility where an abdominal X-ray was performed. Results showed a hair pin in the right upper region of the abdomen. Upon interview, the boy admitted that he had swallowed the hair pin about one month prior to the onset of clinical manifestations. The parents were then reassured by the doctors that the hair pin will eventually pass through the boy's system.

However, the pain did not subside; hence, a computed tomography (CT) scan was ordered. The finding of the test revealed that the hair pin has pierced through the right kidney. The doctors said that the tip of the pin had tarnished and became sharp. Aside from deeply piercing through the right kidney, the hair pin had also gotten through the first segment of the small intestine.

The doctors then removed the hair pin via laparotomy. The boy did not develop any complications and his postoperative recovery went well.

"We have treated a few patients with complications due to swallowed disk batteries as well, but I have never encountered a foreign object that perforates the bowel and gets lodged in the kidney in my practice before," said Dr. Yasmin Abdulaziz Yousef, the corresponding author of the report and part of the medical team that treated the boy.

Yousef advised parents to keep sharp, tiny and hazardous objects away from very young children to prevent events of ingestion. She added that toys with small parts should not be given to children below 3 years and that battery-operated toys should have battery covers screwed tightly in place.

The case was published in BMJ Case Reports on Thursday, Nov. 5.

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