Ornament Hook Stuck In Infant’s Throat For Months Led To Seizures and Brain Lesions

August 26, 2020

A 10-month-old child had an ornamental hook stuck in her esophagus for months before anyone noticed, according to a new case report.

According to the report, the hook tore a hole in her esophagus, causing an infection that spread to her brain and caused seizures. Fortunately, the child recovered after the hook was removed.

According to a report published July 18 in the Journal of Emergency Medicine, the child’s parents brought her to the emergency room after seeing her first seizure. According to the authors from the University of Colorado School of Medicine, at this point, the child had been ill for some time – two months earlier, she began to have frequent fevers that reached 102 degrees Fahrenheit (38.9 degrees Celsius), along with vomiting, vomiting and an aversion to solid food. During this 2-month period, the child lost more than 1 lb. (500 g).

In the emergency room, the child had a mild fever and blood tests showed signs of infection.A CT scan showed six lesions on the child’s brain, the largest being 1.5 inches (4 cm) in diameter. These turned out to be brain abscesses caused by a bacterial infection. The doctors gave the child antibiotics and drained some of the fluid from the abscesses during brain surgery.

After the surgery, they transferred the child to the pediatric intensive care unit, where a routine chest X-ray revealed a foreign body in her esophagus. The child underwent another surgery to remove the foreign body, which turned out to be a metal ornament hook. The hook had penetrated her esophagus and was causing inflammation in her chest cavity. The child had to be fed through a nasal tube until her esophagus healed.

Brain abscesses are rare in children, but it sometimes happens that the infection spreads from the ear or sinuses to the brain. In this case, however, researchers believe the infection spread to the brain through the bloodstream.

Foreign bodies that do not pass within 24 hours have a higher risk of causing complications such as infection. The authors say doctors should consider the possibility of a patient ingesting or inhaling a foreign body if they have a history of coughing, vomiting, and decreased food intake.

They write, “Earlier detection and removal of the foreign body is essential to prevent subsequent complications.”

A week after the hook was removed, the child was able to eat again. She continued to take antibiotics after she was discharged from the hospital and had no further seizures. Some of her brain lesions could not be drained because they were caused by inflammation rather than fluid collection, and the largest of these lesions decreased from 1.1 inches (2.9 centimeters) to 0.02 inches (0.05 centimeters) after three months. The child continued to meet developmental milestones and had no neurological damage, the researchers wrote in the study.