COMPLICATIONS CAUSED BY FOREIGN PARTICLES IN GASTROINTESTINAL TRACT IN CHILDREN

Ingesting or inserting foreign bodies into the lumen of the gastrointestinal tract (GIT) in children is known as a widespread phenomenon. The major portion of foreign bodies entering the stomach and intestine does not cause serious clinical manifestations and is expelled out of the body in a natural way. This article presents cases of rare complications caused by gastrointestinal foreign bodies (GIFB) in children and associated diagnostic and management errors. In some cases, mechanically active GIFB can perforate the gastrointestinal wall resulting in infiltrates, intercellular ab-scesses or general forms of peritonitis. GIFB migrating from the lumen of the gastrointestinal tract through the anterior abdominal wall is a casuist incident. An 11-month-old girl was admitted to the paediatric surgical department for tumour-like mass in the anterior abdominal wall. After examination, tumour-like mass was removed. Histological examination revealed a fibrous fat tissue with leukocyte infiltration and a cavity surrounded by purulent neutrophil infiltrate and granulation tissue. 1 month later, the girl developed an abscess in the area of postoperative scar; after the abscess rupture a fistula formed. Ultrasound investigation of the fistula region made us suspicious of the presence of GIFB. During the operation, the stained fistula lumen was examined up to the peritoneum and a foreign body, a pine needle up to 3 cm in length was found out. The widespread use of domestic electronics with small power elements and magnetic constructors has led to the increase in the number of physically and chemically active GIFB found. The adhesion of magnets at different levels of the gastrointestinal tract can lead to intestinal obstruction, perforation with following fistula formation and as a consequence, to peritonitis. A 7-year-old boy was admitted to the paediatric surgical department with a clinical picture of acute appendicitis. During the operative intervention, three perforated openings in the ileum and a metallic foreign body sized 3 × 0.5 cm in the form of "dumbbells" were found. In the postoperative period, progressing peritonitis arose. X-ray of the abdominal cavity showed a foreign body up to 7 cm in length, consisting of two interconnected parts similar to those removed during the previous operation. During the repeated operation, the perforation of the ascending colon was found out and magnetic foreign bodies were removed. Among the causes leading to entering various foreign bodies into the child's gastrointestinal tract that results in carious complications is Pick disease, which causes a steady craving for the intake of non-food substances. The phenomenon is the most common among mentally retarded children. A boy aged 13 years old, suffering from cerebral palsy with cognitive function disorder, was hospitalized at paediatric surgery department presenting symptoms of acute intestinal obstruction. During the operation, we found the terminal part of the small intestine was injured with numerous foreign bodies that caused perforations and inter-epithelial abscesses. Foreign bodies (sharp-pointed pencil splinters, thick paper balls) were removed. One month after the operation, the boy was re-admitted to the hospital with the signs of intestinal obstruction. During the operation, the conglomerate of foreign bodies (pieces of rubber, cloth and chips) that caused the small intestine obstruction was found and removed. Trichobezoars are the rare form of GIFB that result from eating the hair and are more often found in the stomach and comparatively less often in the small intestine. These formations are usually characteristic of adolescent girls.