Management of Ingested Hijab-Pin

Background and Study Aims: Accidental swallowing of hijab (or turban) pin was reported mainly among adolescent girls. Current guidelines indicate emergent intervention endoscopy in case a long sharp object is found in the gastrointestinal tract. The aims of the current study are to present the results of an observational approach and to assess the need for intervention. Patients and Methods: A retrospective cohort study was conducted including all 5–18-year-old patients who presented with hijab-pin ingestion between 2003 and 2014. The need for intervention was assessed using both univariable and multivariable statistical analyses. Results: Two hundred three cases of hijab-pin ingestion were documented. In the majority of cases, the pin was observed in the stomach (137/203, 67.4%) upon arrival. Most pins that were located at the upper gastrointestinal tract (proximal to the ligament of Treitz) ejected spontaneously (120/169, 71%, Pv = 0.005). The absence of pin progression in an X-ray performed 12 h following presentation was significantly more frequent in the intervention group (46/51, 90%, Pv = 0.001). Conclusions: In most cases, the outcome is spontaneous ejection from the digestive tract. However, if needle location remains unchanged on two consecutive X-rays, an endoscopic intervention is recommended.