Multiple Foreign bodies entrapped at Duodenal Web

An 18-month-old male infant presented with intermittent non-bilious vomiting with pain abdomen for last six months. There was history of localized abdominal distension which gets relieved partially, with vomiting. Patient was born at full term and had no previous medical or surgical history. On examination, patient’s weight was 8.8 kg. Biochemical profile was normal. X-ray abdomen revealed gastric distension with paucity of gas in rest of abdomen. In upper GI study, stomach and duodenum were distended with narrowing of the 2rd part of the duodenum with passage of the contrast distally, suggestive of the perforated duodenal web (Fig.1). At laparotomy, duodenotomy revealed a web with a pin point hole in the center. Multiple FBs were present in the duodenum. The web was excised and the foreign bodies were retrieved (Fig.2). The foreign bodies were mostly buttons, seeds and diamonds. Postoperative period was uneventful.