Calcified sewing needle as a urinary foreign body in a pediatric patient: a case report.

INTRODUCTION AND

IMPORTANCE

Foreign bodies (FBs) in the bladder can result from iatrogenic causes, migration from adjacent organs, penetrating injuries, or self-insertion. They serve as a nidus for calcification and stone formation. While bladder stones related to FBs are occasionally seen in adults, such cases are extremely rare in children.

PRESENTATION OF CASE: A 2.5-year-old girl (10 kg) presented with chronic irritability, abdominal pain, dysuria, and intermittent hematuria for 1 year, unresponsive to antibiotics and antipyretics. Examination was unremarkable, with a leukocyte count of 9900. Urinalysis showed microscopic hematuria and pyuria. Ultrasound revealed a 33 mm echogenic structure in the bladder, which was confirmed by a kidney, ureter, and bladder (KUB) radiograph as a calcified needle. No history of trauma or abuse was reported, and the child's development was normal. Open cystolithotomy was performed, successfully extracting the needle. Postoperatively, a urethral catheter was retained for 2 days and antibiotics were administered. The patient was discharged in good condition on day 3.

CLINICAL DISCUSSION: Bladder FBs in children are rare and present with nonspecific urinary symptoms. Imaging is essential for diagnosis, while management depends on the characteristics of the object and available resources. Endoscopic removal is ideal, but open surgery may be necessary in resource-limited settings or when dealing with rigid, sharp objects.

CONCLUSION

Prompt recognition and early imaging are essential in pediatric bladder FBs. Timely surgical management prevents avoidable complications that LMIC health systems are less equipped to manage once advanced disease develops.