Doctors reveal perils of hair pins, head lice and herbal medicine


Doctors have warned of the dangers of hair pins, head lice and herbal medicines in a series of unusual cases among patients.

Writing in BMJ Case Reports, medics told how a four-year-old boy swallowed a hair pin which then pierced his right kidney.

The boy, from Saudi Arabia, had suffered pain in his upper right abdomen and between his ribs and hip, plus sporadic fever and chills for three months.

His parents repeatedly sought medical advice but an eventual diagnosis of a urine infection did not improve with antibiotics.

The experts said: "A CT of the abdomen showed that a swallowed 'bobby pin' had pierced through the right kidney. This finding explained the boy's symptoms. The pin was removed by laparotomy (surgery) without any subsequent complication."

The doctors who treated the boy said the ends of the hair pin had rusted and become sharp, pierced through the first section of the small intestine and deep into his kidney.

The team, from Jeddah, said that although it is common for youngsters to swallow things, "the foreign object usually passes harmlessly through the gastrointestinal tract.

"Complications of intestinal perforation are unusual unless the foreign body is either a sharp, thin object or a disc battery."

Another story reported in BMJ Case Reports told how a trained herbalist accidentally overdosed on the "deadly nightshade" herbal medicine.

Experts from the adult intensive care department at Oxford University Hospitals NHS Trust said just 50ml of the medicine was enough to have almost fatal effects.

They said: "A 50-year-old woman who was a trained herbalist had purchased an Atropa belladonna (deadly nightshade) preparation.

"Attempting to combat her insomnia, late one evening she deliberately ingested a small portion of this, approximately 50 ml.

"Unintentionally, this was equivalent to a very large (15mg) dose of atropine and she presented in an acute anticholinergic syndrome (confused, tachycardic (high heart rate) and hypertensive (high blood pressure)) to our accident and emergency department.

"She received supportive management in our intensive treatment unit including mechanical ventilation."

They said the woman eventually recovered but warned "this dramatic clinical presentation does highlight the potential dangers posed by herbal remedies.

"Furthermore, this case provides clinicians with an important insight into potentially dangerous products available legally within the UK."

In a further case reported in the BMJ, a 23-year-old women in Saudi Arabia was admitted to A&E and found to have severe iron deficiency possibly caused by a chronic and heavy lice infestation.

She was suffering chest discomfort, palpitations, light-headedness and general fatigue.

Blood tests revealed severe iron deficiency but other tests could not reveal any obvious cause.

Doctors then noticed she had a heavy and chronic head lice infestation, and scratch marks on her scalp. She had poor hygiene due to depression.

The doctors said previous cases of severe iron deficiency have been seen in homeless patients, with limited access to hygiene, which led to lice infestation.