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Conservative versus Interventional Management of Ingested Straight Pins in Adolescent Females: A Retrospective Case Series Illustrating Guideline-Based Decision-Making Purnamasari, Primadita; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1436

Background: The ingestion of sharp foreign bodies (FBs) in adolescents presents a critical management dilemma, balancing conservative observation against the risk of gastrointestinal perforation. In certain cultural contexts, the accidental ingestion of straight pins used for hijabs creates a unique patient cohort. This study aims to illustrate the practical, guideline-based application of divergent management strategies in these specific clinical scenarios. Methods: We conducted a retrospective case series of five female adolescents, aged 13 to 15 years, managed at a single tertiary center for accidental straight pin ingestion. Data on clinical presentation, radiological findings, management strategy (conservative versus endoscopic), and outcomes were extracted and analyzed. Management decisions were dictated by established international guidelines. Results: Three asymptomatic patients (60%) with pins located distal to the duodenum were managed conservatively and experienced spontaneous passage within 2-4 days. Two patients (40%) required therapeutic endoscopy. One underwent emergent removal for a proximally located pin causing respiratory symptoms. The other, despite being asymptomatic, underwent urgent intervention due to the development of a radiological "sentinel loop" and rising inflammatory markers, which revealed an impacted duodenal pin. No complications occurred in any patient. Conclusion: This series demonstrates that while active surveillance is a safe strategy for asymptomatic patients with distally located sharp FBs, clinical silence does not preclude impending complications. Subtle radiological findings, such as a sentinel loop, are crucial indicators that must prompt timely endoscopic intervention to prevent morbidity. The educational value lies in highlighting these critical decision-making triggers.

Beyond 'Blunt': A Pathophysiology-Guided Framework for Managing High-Risk Pediatric Foreign Body Ingestion Fatmala Haningtyas; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1443

Background: Foreign body ingestion is a significant cause of pediatric morbidity. The traditional "blunt" classification is insufficient for risk stratification, as objects like magnets and impacted items pose distinct threats based on their intrinsic properties. This study analyzes how a pathophysiology-based approach, distinguishing active (magnetic) from passive (mechanical) injury mechanisms, guides clinical decision-making. Methods: We conducted a retrospective, descriptive case series at a tertiary pediatric surgical center, reviewing cases from January 2022 to December 2024. Five illustrative cases of high-risk blunt foreign body ingestion were selected to demonstrate the spectrum of management based on the object's potential for harm. Results: The series included five children (aged 3-7 years). A 7-year-old with a single gastric magnet retained for five days developed mucosal injury and required urgent endoscopic removal. A 5-year-old with a recently ingested solitary gastric magnet and a 3-year-old with an impacted pyloric pendant also underwent urgent endoscopic removal. A 6-year-old with a gastric coin had elective endoscopy due to socioeconomic factors. In contrast, a 5-year-old with a coin that passed the pylorus was managed conservatively with spontaneous passage. All patients had successful outcomes. Conclusion: The management of pediatric foreign body ingestion should be dictated by the object's pathophysiological potential for injury, not its shape. Understanding the difference between active magnet-induced pressure necrosis and passive mechanical impaction is paramount for applying guidelines effectively and preventing severe complications. This framework supports a necessary shift from shape-based to mechanism-based risk assessment.

Conservative versus Interventional Management of Ingested Straight Pins in Adolescent Females: A Retrospective Case Series Illustrating Guideline-Based Decision-Making Purnamasari, Primadita; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1436

Background: The ingestion of sharp foreign bodies (FBs) in adolescents presents a critical management dilemma, balancing conservative observation against the risk of gastrointestinal perforation. In certain cultural contexts, the accidental ingestion of straight pins used for hijabs creates a unique patient cohort. This study aims to illustrate the practical, guideline-based application of divergent management strategies in these specific clinical scenarios. Methods: We conducted a retrospective case series of five female adolescents, aged 13 to 15 years, managed at a single tertiary center for accidental straight pin ingestion. Data on clinical presentation, radiological findings, management strategy (conservative versus endoscopic), and outcomes were extracted and analyzed. Management decisions were dictated by established international guidelines. Results: Three asymptomatic patients (60%) with pins located distal to the duodenum were managed conservatively and experienced spontaneous passage within 2-4 days. Two patients (40%) required therapeutic endoscopy. One underwent emergent removal for a proximally located pin causing respiratory symptoms. The other, despite being asymptomatic, underwent urgent intervention due to the development of a radiological "sentinel loop" and rising inflammatory markers, which revealed an impacted duodenal pin. No complications occurred in any patient. Conclusion: This series demonstrates that while active surveillance is a safe strategy for asymptomatic patients with distally located sharp FBs, clinical silence does not preclude impending complications. Subtle radiological findings, such as a sentinel loop, are crucial indicators that must prompt timely endoscopic intervention to prevent morbidity. The educational value lies in highlighting these critical decision-making triggers.

Beyond 'Blunt': A Pathophysiology-Guided Framework for Managing High-Risk Pediatric Foreign Body Ingestion Fatmala Haningtyas; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1443

Background: Foreign body ingestion is a significant cause of pediatric morbidity. The traditional "blunt" classification is insufficient for risk stratification, as objects like magnets and impacted items pose distinct threats based on their intrinsic properties. This study analyzes how a pathophysiology-based approach, distinguishing active (magnetic) from passive (mechanical) injury mechanisms, guides clinical decision-making. Methods: We conducted a retrospective, descriptive case series at a tertiary pediatric surgical center, reviewing cases from January 2022 to December 2024. Five illustrative cases of high-risk blunt foreign body ingestion were selected to demonstrate the spectrum of management based on the object's potential for harm. Results: The series included five children (aged 3-7 years). A 7-year-old with a single gastric magnet retained for five days developed mucosal injury and required urgent endoscopic removal. A 5-year-old with a recently ingested solitary gastric magnet and a 3-year-old with an impacted pyloric pendant also underwent urgent endoscopic removal. A 6-year-old with a gastric coin had elective endoscopy due to socioeconomic factors. In contrast, a 5-year-old with a coin that passed the pylorus was managed conservatively with spontaneous passage. All patients had successful outcomes. Conclusion: The management of pediatric foreign body ingestion should be dictated by the object's pathophysiological potential for injury, not its shape. Understanding the difference between active magnet-induced pressure necrosis and passive mechanical impaction is paramount for applying guidelines effectively and preventing severe complications. This framework supports a necessary shift from shape-based to mechanism-based risk assessment.

The Pointed Challenge: Endoscopic Management of an Ingested Sharp Foreign Body and a Synthesis of Modern Techniques Sindhu Nugroho Mukti; Sigit Adi Prasetyo; Bernardus Parish Budiono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1465

Background: The ingestion of sharp-pointed foreign bodies constitutes a high-acuity medical emergency, distinguished from other ingested objects by its significant potential for severe complications, including visceral perforation and hemorrhage. While flexible endoscopy has emerged as the cornerstone of management, its successful application hinges on a systematic, protocol-driven approach. This manuscript presents a case of an ingested straight pin and uses it as the framework for a critical synthesis of modern diagnostic and therapeutic strategies. Case presentation: A 40-year-old female presented to the emergency department, hemodynamically stable and completely asymptomatic, two hours after accidentally swallowing a straight pin. A benign abdominal examination belied the potential danger. Plain radiography confirmed a single, sharp metallic object in the gastric antrum. An urgent esophagogastroduodenoscopy under general anesthesia was performed. The pin was securely grasped with rat-tooth forceps and extracted without incident. The patient's recovery was uneventful, and she was discharged on the first postoperative day. Conclusion: This case provides a high-fidelity validation of current international guidelines, demonstrating that a protocol-driven approach—encompassing rapid triage, definitive imaging, and urgent therapeutic endoscopy—is both safe and maximally effective for upper gastrointestinal sharp foreign bodies. The successful outcome underscores the critical importance of this management algorithm in preventing progression to life-threatening complications. This case-driven synthesis reinforces that adherence to a rigorous, evidence-based protocol is the most effective strategy to navigate this pointed clinical challenge and consistently achieve optimal patient outcomes.

The Pointed Challenge: Endoscopic Management of an Ingested Sharp Foreign Body and a Synthesis of Modern Techniques Sindhu Nugroho Mukti; Sigit Adi Prasetyo; Bernardus Parish Budiono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1465

Background: The ingestion of sharp-pointed foreign bodies constitutes a high-acuity medical emergency, distinguished from other ingested objects by its significant potential for severe complications, including visceral perforation and hemorrhage. While flexible endoscopy has emerged as the cornerstone of management, its successful application hinges on a systematic, protocol-driven approach. This manuscript presents a case of an ingested straight pin and uses it as the framework for a critical synthesis of modern diagnostic and therapeutic strategies. Case presentation: A 40-year-old female presented to the emergency department, hemodynamically stable and completely asymptomatic, two hours after accidentally swallowing a straight pin. A benign abdominal examination belied the potential danger. Plain radiography confirmed a single, sharp metallic object in the gastric antrum. An urgent esophagogastroduodenoscopy under general anesthesia was performed. The pin was securely grasped with rat-tooth forceps and extracted without incident. The patient's recovery was uneventful, and she was discharged on the first postoperative day. Conclusion: This case provides a high-fidelity validation of current international guidelines, demonstrating that a protocol-driven approach—encompassing rapid triage, definitive imaging, and urgent therapeutic endoscopy—is both safe and maximally effective for upper gastrointestinal sharp foreign bodies. The successful outcome underscores the critical importance of this management algorithm in preventing progression to life-threatening complications. This case-driven synthesis reinforces that adherence to a rigorous, evidence-based protocol is the most effective strategy to navigate this pointed clinical challenge and consistently achieve optimal patient outcomes.

Beetroot (Beta vulgaris) Extract: A Potential Therapeutic Agent for Modulating Post-Cholecystectomy Colonic Inflammation? An In Vivo Evidence Review Mahmudin Ardian Ashadi; Sigit Adi Prasetyo; Yora Nintida
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i4.1262

Background: Cholecystectomy, while a common and effective treatment for symptomatic gallstones, can induce alterations in bile flow and gut microbiota composition, potentially leading to colonic inflammation. Beetroot (Beta vulgaris) extract, rich in betalains, nitrates, and other bioactive compounds, has demonstrated anti-inflammatory and antioxidant properties in various models. This systematic review evaluates the in vivo evidence for the efficacy of beetroot extract in modulating colonic inflammation following cholecystectomy. Methods: A systematic search of PubMed, Scopus, Web of Science, and Embase databases was conducted from January 2013 to May 2024, using keywords related to "beetroot," "Beta vulgaris," "cholecystectomy," "colon," "inflammation," and "in vivo." Studies investigating the effects of beetroot extract on colonic inflammation in animal models post-cholecystectomy were included. Data on inflammatory markers, histological changes, oxidative stress markers, and gut microbiota alterations were extracted. Results: Seven in vivo studies met the inclusion criteria. Beetroot extract administration was associated with significant reductions in colonic levels of pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) in five studies. Data showed an average reduction of TNF-α by 35% (p < 0.01), IL-6 by 28% (p < 0.05), and IL-1β by 42% (p < 0.001) across these five studies. Four studies reported improvements in histological scores of colonic inflammation, indicating reduced tissue damage. Three studies demonstrated a decrease in MPO activity, a marker of neutrophil infiltration, with data showing an average reduction of 25% (p < 0.05). Conclusion: The available in vivo evidence, albeit limited, suggests that beetroot extract possesses significant potential for mitigating colonic inflammation following cholecystectomy. The observed anti-inflammatory effects are likely mediated by a combination of betalain-induced antioxidant and anti-inflammatory actions, nitrate-derived nitric oxide signaling, and modulation of the gut microbiota.

Modulation of Inflammatory and Regenerative Pathways by Channa striata Extract in End-to-End Anastomotic Wound Repair: A Systematic Review Faizurrahman Andi Kusuma; Sigit Adi Prasetyo; Endang Sri Lestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i4.1264

Background: Intestinal anastomotic healing is a complex process, often complicated by inflammation and impaired regeneration, leading to leakage and stricture. Channa striata (snakehead fish) extract, traditionally used for wound healing, possesses bioactive compounds with potential anti-inflammatory and regenerative properties. This systematic review aimed to critically appraise the in vivo evidence for the effects of Channa striata extract on inflammatory and regenerative pathways in end-to-end anastomotic wound repair. Methods: A comprehensive search of PubMed/MEDLINE, Scopus, Web of Science, Embase, and Cochrane Library databases was conducted for studies published between 2013 and 2024. Inclusion criteria comprised in vivo studies using animal models with end-to-end intestinal anastomosis, evaluating Channa striata extract versus a control, and reporting on relevant inflammatory and regenerative markers. Data extraction and risk of bias assessment (using SYRCLE's tool) were performed. Results: Seven studies met the inclusion criteria. These studies, primarily using rat models, demonstrated that Channa striata extract significantly modulated key inflammatory and regenerative pathways. Specifically, the extract reduced pro-inflammatory cytokines, increased anti-inflammatory cytokines, enhanced growth factor expression, and promoted collagen deposition at the anastomotic site. These effects were associated with improved anastomotic bursting pressure and reduced leakage rates. Risk of bias varied across studies, with some limitations in blinding and allocation concealment. Conclusion: Channa striata extract shows promise as a therapeutic agent for promoting anastomotic healing by modulating key inflammatory and regenerative pathways. However, further high-quality, standardized studies are needed to confirm these findings, elucidate precise mechanisms, and optimize extract formulation and dosage before clinical translation.

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