J Korean Soc Traumatol.  2013 Dec;26(4):304-307.

A Case of Successful Endoscopic and Conservative Treatment for Intentional Ingestion of Sharp Foreign Bodies in the Alimentary Tract

• Park JM
• Kim SY
• Chung IY
• Kim WS
• Shin YC
• Kim YC
• Park SH

Abstract

Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

Keyword

Foreign bodies; Gastrointestinal tract; Endoscopy; Observation

MeSH Terms

Adult
Alcoholism
Anxiety Disorders
Deglutition Disorders
Eating*
Emergencies
Endoscopy
Esophagus
Foreign Bodies*
Gastrointestinal Tract
Humans
Length of Stay
Liver Cirrhosis, Alcoholic
Male
Middle Aged
Neck Pain
Physical Examination
Prisons
Pylorus
Sleep Initiation and Maintenance Disorders
SNARE Proteins
Stomach
SNARE Proteins