A 2 yr old with accidental Iron Nail ingestion

A 2 yr old baby Chief Complaints Alleged h/o accidental ingestion of iron nail 2 hrs back f/b one episode of hemetemesis Investigations Xray

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F B nail in mid of oesophagus with h/o one episode of hematamesis Nail is angulated and likely piercing or injuring oesophageal endothelium I will suggest to remove the F B by endoscopy urgently rather allowing to pass as angulated f b likely to stuck any where while negotiating.

Thanx dr Praveen Yograj
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cannulate the baby inj tranexa to control bleeding inj omeprazole iv antibiotics iv fluids . stablize the baby first . ask for vaccination . followed by endoscopic removal of the nail .

The angled iron nail is in oesophagus. Urgent OESOPHAGEAL endoscopic removal of the nail is indicated as it has already caused hematemesis and may cause G.I perforation

Iron nail is angled! Therefore there is high chance of perforation of intestine/ oesophagus Adv Oesophageal Endoscopy and removal of nail

FBs lodged in the esophagus for a long time may be associated with complications such as mucosal ulceration, esophageal obstruction, perforation, intrinsic stenosis, and esophageal diverticulum.

Endoscopic nail removal

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