Endoscopic Retrieval of Impacted Ingested Cow Skin-Kpomo in an Adolescent Female: A Case Report Highlighting a Cultural Dietary Risk Factor

Abstract

Background: Oesophageal food bolus impaction is a gastrointestinal emergency requiring prompt endoscopic intervention. While meat bolus impaction is well documented in Western literature, regional dietary practices, such as the ingestion of cow skin (kpomo), may predispose to impaction in adolescents. Case Presentation: A 16-year-old female presented with sudden retrosternal chest pain, vomiting, and dyspnoea after swallowing unchewed kpomo. Initial management included intravenous proton pump inhibitor therapy and failed nasogastric tube insertion, suggesting complete oesophageal obstruction, which is a red flag sign. Upper gastrointestinal endoscopy revealed distal oesophageal impaction. Initial retrieval with a basket was unsuccessful; successful extraction was achieved using a polypectomy snare following distal manipulation. Post-procedure recovery was uneventful. Conclusion: This case highlights kpomo as a culturally specific risk factor for oesophageal impaction and underscores the importance of timely endoscopic management to prevent complications.