Penetrating injury of the soft palate - a case report

Young children have, unfortunately, the proclivity for running with objects holding in their mouth and falling. Then it comes to penetrating injuries in the oral cavity. Initial symptoms are rather bland, and often the small wounds heal uneventful without surgical intervention. In the primary therapy of these children also the question of any remaining foreign body in the wound comes up. An 11-month-old boy fell at home while crawling with a pen in his mouth. On examination the child was awake, quiet, and had no dyspnoea, cough, or even neurological impairment. The approximately 1.5 cm long wound in the soft palate did not bleed. Since there was no suspicion of a foreign body, surgical repair was renounced, and follow-up consultation for the next day was arranged. At home, the mother detected, that the 1 cm long metal tip of the ballpoint pen lacked. Under general anaesthesia the foreign body was found and removed endoscopic assisted from the atlanto-occipital area. In children with penetrating wounds of the soft palate it must to be alert also to an unexpected remaining foreign body in the posterior pharyngeal wall. In the case report it was initially not supposed, that the metal tip of a ballpoint pen remained in the wound. Therefore, we recommend looking at the object of injury in order to initiate further diagnostics (CT, MRI) to search for a foreign body. Keywords: penetrating injury, oral cavity, foreign body