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Case Reports
. 2020:70:60-63.
doi: 10.1016/j.ijscr.2020.04.019. Epub 2020 May 7.

Ingestion of huge number of metallic nails impacted in the stomach and cecum in a mentally abnormal woman: Case report

Ayad Ahmad Mohammed  1
Affiliations
Case Reports

Ingestion of huge number of metallic nails impacted in the stomach and cecum in a mentally abnormal woman: Case report

Ayad Ahmad Mohammed. Int J Surg Case Rep. 2020.

Abstract

Background: Foreign bodies may be ingested unconsciously, intentionally or in patients who have psychological abnormalities. The majority of foreign bodies are passed smoothly with no problems if they passed the esophagus, however some may be lodged in areas of anatomical narrowing which may require endoscopic or surgical intervention.

Case presentation: A 37-year -old mentally abnormal woman presented to the emergency department complaining from abdominal pain for 2 days. The family reported a history of ingestion of multiple metallic nails one week before presentation. Abdominal examination showed generalized tenderness and guarding. Plain abdominal X-ray showed multiple metallic nails in the upper abdomen and the right lower abdomen. Laparotomy was performed, one of the nails was causing perforation of the gastric wall, huge number of metallic nails were extracted from the stomach and cecum, appendectomy was performed.

Conclusion: Ingestion of sharp and long foreign bodies usually requires surgical intervention, after surgery close observation and psychological consultation is required to prevent repeated ingestions.

Keywords: Acute abdomen; Endoscopy; Foreign bodies; Laparotomy; Metallic nails; Plain abdominal X-ray.

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Figures

Fig. 1
Fig. 1
Plain abdominal X-rays of the abdomen showing multiple metallic nails in the stomach and the terminal ileum.
Fig. 2
Fig. 2
An intraoperative picture showing the stomach filled with large number of metallic nails.
Fig. 3
Fig. 3
An intraoperative picture showing the gastric cavity with containing the metallic nails.
Fig. 4
Fig. 4
An intraoperative picture showing the extraction of the nails from the stomach.
Fig. 5
Fig. 5
An intraoperative picture showing the closure of the stomach using a slowly absorbable suture material.
Fig. 6
Fig. 6
An intraoperative picture showing appendicostomy and the extraction of metallic nails from the cecum.
Fig. 7
Fig. 7
A picture showing the metallic nail, some elastic rubbers, and safety pins which were extracted from the gastric and caecal lumens.
See this image and copyright information in PMC

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