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Journal of Trauma and Injury 2013;26(4):304-307.
A Case of Successful Endoscopic and Conservative Treatment for Intentional Ingestion of Sharp Foreign Bodies in the Alimentary Tract
Jong Min Park, Seong Yup Kim, Il Yong Chung, Woo Shik Kim, Yong Chul Shin, Yeong Cheol Kim, Sei Hyeog Park
Department of Trauma Surgery, National Medical Center, Seoul, Korea. surgery2002@medimail.co.kr
고의로 섭취한 커터칼날의 내시경 및 보존적 치료 증례 보고
박종민, 김성엽, 정일용, 김우식, 신용철, 김영철, 박세혁
국립중앙의료원 외상외과
Received: 30 October 2013   • Revised: 16 November 2013   • Accepted: 20 December 2013
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.
Key Words: Foreign bodies; Gastrointestinal tract; Endoscopy; Observation
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