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Infant with accidental ingestion of heated tobacco

Authors:
Taichi Maruyama
Taichi Maruyama
Taichi Maruyama
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Daiki Sasaoka at Kumamoto University
Daiki Sasaoka
Yuko Fujii
Yuko Fujii
Yuko Fujii
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Sayo Mori
Sayo Mori
Sayo Mori
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Received: 17 April 2023 Accepted: 18 April 2023
DOI: 10.1002/emp2.12959
IMAGES IN EMERGENCY MEDICINE
Pediatrics
Infant with accidental ingestion of heated tobacco
Taichi Maruyama MD Daiki Sasaoka MD Yuko Fuj i i MD Sayo Mori MD
Takahito Inoue PhD Atsushi Ogawa PhD
Department of Pediatrics, Fukuoka University Chikushi Hospital, Fukuoka, Japan
Correspondence
Taichi Maruyama, MD, Department of Pediatrics, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Email: taichimaruyama323@gmail.com
1PATIENT PRESENTATION
A 10-month-old girl was brought to the emergency department by
her mother for accidental heated tobacco (iQOS ILUMA, TEREA Heat
stick) ingestion. After her mother noticed that some heated tobacco
sticks on the sofa were missing, she was brought to the hospital rapidly.
Her vital signs were stable, and her general appearance was lethar-
gic. On physical examination, there were no abnormalities. Because
it was within 1 hour of accidental ingestion and there was a poten-
tial nicotine intoxication, we judged that gastric lavage was indicated.
After we inserted the nasogastric tube for gastric lavage, the radio-
graph presented a rectangular foreign body in the stomach. The size of
the foreign body was 12 mm long and 3 mm wide. (Figure 1)
2DIAGNOSIS
2.1 Heated tobacco blade ingestion
Before the gastric lavage, she vomited the tobacco leaves and the blade
with sharp edges. There was no oral bleeding or bloody stool. She was
discharged from the hospital with 24-hour follow-up.
Since the launch of heated tobacco products, the number of sales
has been growing worldwide.1In Japan, younger people tend to use
heated tobacco.2In addition, the case of accidental ingestion of heated
tobacco has been increasing.3Clinical physicians need to know that
depending on the type of heated tobacco, a blade is built into the stick.
(Figure 2) Its shape is sharp, and the possibility of physical damage to
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial- NoDerivs License, which permits use and distribution in any
medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
© 2023 The Authors. JACEP Ope n publishedby Wiley Periodicals LLC on behalf of American College of Emergency Physicians.
FIGURE 1 Abdominal radiograph identifying a foreign body (red
circle and arrow) and the iQOS stick the mother brought (white circle
and arrow).
the digestive tract cannot be denied. It may be better to remove the
blade using a magnet catheter.
ACKNOWLEDGMENTS
This research received no specific grant from any funding agency in the
public, commercial, or not-for-profit sectors.
JACEP Ope n 2023;4:e12959. wileyonlinelibrary.com/journal/emp2 1of2
https://doi.org/10.1002/emp2.12959
2of2 MARUYAMA ETAL.
FIGURE 2 iQOS stick with a sharp blade.
ORCID
Taichi Maruyama MD https://orcid.org/0000-0003-3483-7194
REFERENCES
1. Centers for Disease Control and Prevention. Heated Tobacco Prod-
ucts. Accessed March 7, 2023. https://www.cdc.gov/tobacco/basic_
information/heated-tobacco- products
2. Igarashi A, Aida J, Kusama T, et al. Heated tobacco products
have reached younger or more affluent people in Japan. JEpi-
demiol. 2021;31(3):187-193. Epub 2020 March 28. doi:10.2188/
jea.JE20190260
3. Japan Poison Information Center. The number of consultations on
heated tobacco is increasing. Topic related to addiction. Accessed
March 7, 2023. https://www.j-poison-ic.jp/report/180803
How to cite this article: Maruyama T, Sasaoka D, Fujii Y, Mori
S, Inoue T, Ogawa A. Infant with accidental ingestion of heated
tobacco. JACEP Open. 2023;4:1–2.
https://doi.org/10.1002/emp2.12959
Available via license: CC BY-NC-ND 4.0
Content may be subject to copyright.
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