A 37-year-old male prisoner was sent to our emergency department for abdominal pain. His past medical history was uneventful except for the diagnosis of psychopathic personality. He had epigastric tenderness on physical examination. A plain abdominal x ray demonstrated multiple foreign bodies (fig 1). There were no signs of intestinal obstruction or free intraperitoneal air in the abdomen. After some difficulty in obtaining a history, we discovered that he had been ingesting objects that he had obtained over the previous 1–2 weeks.
Figure 1.
Plain abdominal x ray showing multiple foreign bodies. There were no signs of intestinal obstruction or perforation.
We performed an endoscopy of the upper gastrointestinal tract under sedation anaesthesia. There were mucosal tears in the stomach. We observed one impacted nail clipper (fig 2A) and one tie clip which had a sharp needle (fig 2B), located in the duodenum. Successful endoscopic removal of these two foreign bodies was performed. The patient was hospitalised and closely observed for signs of perforation or intestinal obstruction. Other foreign bodies passed through the intestinal tract uneventfully. There was no sign of any foreign bodies on the control plain abdominal x ray when the patient was discharged on day 9.
Figure 2.
(A) Endoscopic view of the impacted nail clipper in the duodenum. (B) Endoscopic removal of the tie clip.
Footnotes
Competing interests: none.
Patient consent: Patient/guardian consent was obtained for publication
