Endoscopic Retrieval of Impacted Ingested Cow Skin-Kpomo in an Adolescent Female: A Case Report Highlighting a Cultural Dietary Risk Factor
Victor Wagozie *
Rivers State University and Rivers State Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
Iseke Ogelemen Praise
Department of surgery, Rivers State University Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Oesophageal food bolus impaction is a gastrointestinal emergency requiring prompt endoscopic intervention. While meat bolus impaction is well documented in Western literature, regional dietary practices, such as the ingestion of cow skin (kpomo), may predispose to impaction in adolescents.
Case Presentation: A 16-year-old female presented with sudden retrosternal chest pain, vomiting, and dyspnoea after swallowing unchewed kpomo. Initial management included intravenous proton pump inhibitor therapy and failed nasogastric tube insertion, suggesting complete oesophageal obstruction, which is a red flag sign. Upper gastrointestinal endoscopy revealed distal oesophageal impaction. Initial retrieval with a basket was unsuccessful; successful extraction was achieved using a polypectomy snare following distal manipulation. Post-procedure recovery was uneventful.
Conclusion: This case highlights kpomo as a culturally specific risk factor for oesophageal impaction and underscores the importance of timely endoscopic management to prevent complications.
Keywords: Cow skin (kpomo), Oesophageal food bolus impaction, adolescent, endoscopy, West Africa, foreign body removal