Surgical Management of Needle Ingestion in a Low-resource Setting: A Two-Case Report

Abstract

Foreign body ingestion constitutes a significant clinical and emergency concern, particularly among pediatric populations but also affecting adults, often leading to serious or life-threatening complications. Presentation commonly varies depending on the ingested object's type and location; potential squeal include mucosal injury, perforation, mediastinitis, and abscess formation. This report details two cases of sharp foreign body ingestion with distinct predisposing circumstances: (1) an 11-year-old boy who ingested a sewing needle following peer provocation, and (2) an 18-year-old female fashion designer who accidentally swallowed a safety pin in the workplace. Both patients presented with neck discomfort and localized tenderness, and radiographs confirmed transverse positioning of the foreign bodies within the upper esophagus. Due to the absence of available emergency endoscopy services, surgical intervention under general anesthesia was performed successfully in both instances. A transverse cervical approach allowed the safe extraction of the foreign bodies without injury to adjacent structures. Postoperative recovery was uneventful in both patients, with satisfactory outcomes following short periods of nil per os and antibiotic therapy. These cases underscore the necessity of prompt diagnosis and individualized management in resource-limited settings, where surgical retrieval may remain the mainstay when less invasive methods are unavailable. The report highlights the importance of public health education to mitigate risk factors; intentional or accidental and advocates for improved access to endoscopic services. Early intervention is critical to minimizing morbidity and preventing dire complications in cases of sharp foreign body ingestion, especially in low-resource settings.