A needle in the colon, the risk of ingested foreign objects: a case report

Accidental Sewing Pin Ingestion by a Tailor: A Case Report and Literature Review

Foreign body ingestion is a frequently encountered emergency in healthcare institutions. It mostly affects pediatric populations, although it can also affect adults with developmental delays, those with psychiatric diseases, drug abusers, and prisoners. Endoscopy is a diagnostic and treatment method for suspected foreign body ingestion. In this article, we discuss a 45-year-old tailor who swallowed a sewing pin while at work. The abdominal X-ray showed a needle-shaped metal shadow in the stomach region. During an upper endoscopy, it was discovered that a sewing pin with a sharp edge was stuck in the pylorus. The sewing pin was extracted endoscopically, and the patient was discharged the same day in good condition. Since the estimated risk of complications of foreign body ingestion in the adult population is about 35%, and the most common complications include impaction, laceration, bleeding, or perforation of the gastrointestinal wall, endoscopic or surgical removal is necessary. This also emphasizes the importance of a careful endoscopic evaluation of some at-risk occupations for foreign body ingestion with or without gastrointestinal complaints.

Do not open wide; accidentally swallowed dental mold causing bowel obstruction. A case report

Foreign body ingestion is a common condition in daily practice; fortunately, most cases do not require endoscopic or surgical treatment, as most foreign bodies pass through the intestine without injuring it. Although mainly seen in children, adults can also be affected, especially in accidental situations and suicide attempts. Therefore, the clinical history and the environment in which the event occurred are essential for a rapid diagnosis. This can be even more challenging as most adult patients are rarely aware of ingestion. Therefore, a high index of suspicion is necessary. Therapy will depend on the foreign body’s size, shape and material; treatment should not be delayed if complications are detected. We present a case of a 34-year-old man who accidentally swallowed the mold of his teeth while undergoing a dental procedure. Subsequently, he presented with an intestinal obstruction that required surgery. Fortunately, he made a full recovery.

Intestine perforation by an accidental ingested SARS-CoV-2 nasopharyngeal swab; a case report

Introduction and importance

Gastrointestinal tract perforations as a result of foreign body ingestion are rare. Most ingested foreign bodies pass the intestines without complications. However, in 1 % of cases intestinal perforation occurs. We present the case of a 56-year old patient with an extensive surgical medical history who presented at the emergency department with progressive abdominal pain two weeks after accidental SARS-CoV-2 swab ingestion.

Case presentation

On presentation patient was tachycardic and had generalized abdominal tenderness. A CT scan showed free intraperitoneal air and fatty infiltration of the ileocecal anastomosis (after an ileocoecal resection at the age of 46) continuing to the distal sigmoid. Emergency exploratory laparotomy revealed a covid swab in the abdominal cavity with an indurated area of the sigmoid without perforation. Post-operative care was uneventful, and patient was dismissed after four days.

Clinical discussion

Due to his medical history and the fact he was advised to regularly self-test for COVID, he routinely performed an oropharyngeal swab. Unfortunately, this resulted in swallowing the swab. A perforation tends to happen in regions of acute angulation, such as an anastomosis. Although the CT scan suggested the perforation was at the ileocecal anastomosis, no perforation was found during surgery, while the swab was found loose in the peritoneal cavity.

Conclusion

Initial treatment should focus on endoscopic removal. In the case of gasto-intestinal perforation, surgery becomes the treatment of choice. A foreign body can migrate to peritoneal cavity without peritonitis or visible perforation perioperative.

•

To the authors best knowledge this is the first case of intestinal perforation after an ingested SARS-CoV-2 nasopharyngeal swab.

•

A foreign body can migrate to peritoneal cavity without peritonitis or visible perforation perioperative.

•

If endoscopy fails to remove it and there is a high risk of perforation, surgical removal should be considered before severe complications develop.

•

In the case of gasto-intestinal perforation, surgery becomes the treatment of choice.