Endoscopy guided retrieval of gastric foreign body by mini laparotomy following PEG principle in a toddler

This case report describes a novel hybrid approach for retrieval of a retained gastric foreign body in a toddler. A 1.5-year-old child presented with ingestion of a metallic alphabet that remained in the stomach for 23 days. Because of the large size and sharp angles of the object, endoscopic retrieval alone posed a significant risk of oesophageal injury. Endoscopic assessment was therefore combined with a mini laparotomy following the principle of percutaneous endoscopic gastrostomy (PEG). The foreign body was successfully removed intact under endoscopic guidance through a small gastrotomy. The patient had an uneventful recovery, resumed oral feeding within 24 hours, and was discharged the following day. This hybrid endoscopy-assisted surgical technique may provide a safe and effective alternative for removal of large or complex gastric foreign bodies in young children