Case of bobby pin piercing kidney reported in 4-year-old

(HealthDay)—A swallowed bobby pin can be cause for concern, capable of piercing through the kidney, according to a case report published online Nov. 5 in BMJ Case Reports.

Sultan Almuallem, from the National Guard Health Affairs in Jeddah, Saudi Arabia, and colleagues describe the case of a 4-year-old boy, without medical illness, who presented to several medical facilities reporting right upper quadrant and right flank pain, intermittent fever, and chills, not concurrent with the pain, for three months.

The researchers note that during earlier assessment a bobby pin was identified on abdominal X-ray. The patient disclosed having ingested a bobby pin one month prior to symptom onset; the parents were told that it would pass naturally. On presentation to the emergency department, the patient was found to have mild tenderness in the right upper quadrant. On computed tomography of the abdomen, a foreign body was found to be traversing through the second part of the duodenum and impaling the middle zone of the right renal parenchyma (full penetration). The patient was taken for laparotomy; two rusted sharp ends of the bobby pin were identified and removed, without subsequent complications. The postoperative recovery was uneventful.

"Spontaneous passage is the main outcome regarding most ingested objects, but, a high risk of perforation is associated with sharp, thin objects, ranging from 15 to 35 percent," the authors write.

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