ENDOABDOMINAL FOREIGN BODY IN AN INFANT: A CASE REPORT

A 40 days old newborn male was brought to the Emergency Paediatric Department by his parents at 8:00 a.m. suffering from abdominal distension, acute constipation and persistently crying. He is the first born of the couple, breast-fed and otherwise healthy. Up till the previous afternoon, the baby was perfectly normal and had evacuated regularly after the mid-day meal. In the hours that followed, he complained of lack of appetite, vomiting, fever and had recurrent crisis of crying that, during the night, became interminable. On medical examination the child appeared in general good health, but looked to be suffering greatly. The abdomen was tense and painful. Abdominal examination showed a hard and movable mass at lower quadrants. Ultrasound study and X-ray investigation confirmed the presence of a mass localised at sigma level and digital examination revealed an empty rectum and a mass could be palpated, with difficulty, as a high \u201cfaecaloma\u201d. The anus was gaping and bleeding. A first therapeutical approach was an attempt to remove the \u201cfaecal impaction\u201d with rectal washing for some days. This treatment proved to be unsuccessful. On the fifth day we decided to remove the faecal mass by sedation in operating room. By the rectal approach some pieces of the mass were removed and they were discovered to be fragments of a vegetable. A laparatomy proved necessary to remove a big carrot (13 cm length and 3 cm width) within the sigma, split into two fragments. The parents, informed immediately, expressed surprise and incredulity and confirmed that only they and some close relatives look care of the baby at all times. The impossibility to attribute the finding of this inner foreign body to an accidental event left us no choice, but to report the case immediately to a magistrate