Surgical Management of Needle Ingestion in a Low-Resource Setting: A Narrative Review and Two Case Reports

Foreign body ingestion constitutes a significant clinical emergency, particularly among the pediatric age group but also affecting adults, often leading to serious or life-threatening complications. Presentation commonly varies depending on the ingested object's type and location; potential sequelae include mucosal injury, perforation, mediastinitis, and abscess formation. We report two cases of sharp foreign body ingestion with distinct predisposing circumstances: The first case, an 11-year-old boy who ingested a sewing needle following peer provocation. The second case, an 18-year-old female fashion designer who accidentally swallowed a safety pin in the workplace. Both patients presented with neck discomfort and localized tenderness, and plain X-ray confirmed the presence of the foreign bodies in the upper esophagus. Due to the lack of emergency endoscopy services, surgical intervention under general anesthesia was performed successfully in both instances. A transverse cervical approach allowed safe extraction of the foreign bodies without injury to adjacent structures. Postoperative recovery was uneventful in both patients, with satisfactory outcomes following short periods of nil per oral and antibiotic prophylaxis. This report emphasizes the urgent need for timely diagnosis and tailored management approaches in resource-limited settings, where surgical retrieval remains the primary treatment option in the absence of less invasive alternatives.