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Carcinoma of the pancreas presenting with hemobilia

1986; Elsevier BV; Volume: 32; Issue: 4 Linguagem: Inglês

10.1016/s0016-5107(86)71862-2

1097-6779

Safiul Hasan, Joseph Quintana, Yousuf Siddiqui, Victor Maldonado,

Kawasaki Disease and Coronary Complications

A 5-year-old boy was seen several times because of retrosternal pain, cough, anorexia, and failure to thrive.At the last visit a chest x-ray revealed a metallic foreign body at the superior third of the thoracic esophagus.Once the mother was informed of the diagnosis, she recalled that 8 months before, the boy, being in perfect health, had suddenly been afflicted by a coughing spell and vomiting, telling her that he had swallowed a coin.She took him to the emergency room where he was examined by a physician, but no x-ray was taken.She afterwards forgot the incident.Once the diagnosis was made, the foreign body was retrieved endoscopically under ketamine anesthesia, using the Olympus GIF-IT panendoscope and "alligator jaws" grasping forceps.The postextraction endoscopic examination of the esophagus showed two deep ulcers with edematous edges where the foreign body had lodged.The foreign body, a coin 24 mm in diameter, showed signs of corrosion.The presence of copper oxide was revealed by chemical analysis.One month later, endoscopic study showed complete healing of the ulcers without reduction of the esophageal lumen.The boy had recuperated from his respiratory problem and showed good appetite.Long-standing foreign bodies in the stomach, duodenum, small intestine, and colon have been noted. 4-6 In the esophagus this is especially dangerous because of the risk of perforation.In this case, both the boy's mother and the physician who had first examined him did not realize that a long lasting and distressing illness could be caused by a retained coin in the esophagus.