title: [Safe extraction of an impacted open safety pin from the esophagus: a new technique and five case studies].
abstract: Esophageal foreign bodies are common, especially in children less than 5 years old. However, the presence of an open safety pin in the esophagus is quite rare. When this occurs, immediate removal of the safety pin is recommended due to its propensity to pierce the esophagus and surrounding structures causing severe and sometimes even lethal complications. Between the years 1990 and 2003, fifteen infants were referred to the Department of Otolaryngology-Head and Neck Surgery at the Rambam Health Care Campus with a history of safety pin ingestion. Plain neck, chest and abdomen radiographs showed the presence of an open safety pin impacted in the esophagus and pointing upwards in nine of the cases, and in the remainder (six infants) a closed pin was demonstrated in the stomach or in the duodenum. This report focuses on five cases in which during esophagoscopy only the clasp of the safety pin was visible, whereas the sharp point was impossible to be grasped, as it seemed to be stuck in the mucosa of the esophagus. In these cases the pin was pushed into the stomach, where it was closed, and then it was pulled outside without any harm to the mucosa or the gastric and esophageal walls. We present a new technique on how to safely close an open safety pin in the stomach and remove it, without any complications, using a flexible endoscope.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rambam-Health Care Campus and The Bruce Rappaport Faculty of Medicine, The Technion, Haifa. golz@netvision.net.il
authors.forename: Avishay
authors.initials: A
authors.lastname: Golz
authors.forename: Arie
authors.initials: A
authors.lastname: Gordin
authors.forename: Aviram
authors.initials: A
authors.lastname: Netzer
mesh_terms: D002675:Child, Preschool; D004947:Esophagus / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012449:Safety