Citation

Al-Faham FSM, Al-Hakkak SMM. Ann. Med. Surg. (Lond.) 2020; 54: 82-84.

Copyright

(Copyright © 2020, Surgical Associates, Publisher Elsevier Publishing)

DOI

10.1016/j.amsu.2020.04.039

PMID

unavailable

Abstract

INTRODUCTION: The swallowing of foreign bodies can be accidental or intentional. The majority of the cases of accidental foreign body ingestion are observed in children. In adults, foreign body ingestion can be accidental, related to specific pathological changes of the digestive tract, or deliberate, as observed in patients with psychiatric diseases or in those released from the prison. Case presentation: A 42-year-old male was admitted to the emergency department with symptoms including choking, drooling from the mouth, holding his neck, and aphonia. He had a history of psychiatric illness with suicidal ingestion of a foreign body. After stabilization, he was sent for chest radiograph, which revealed a significant radiopaque shadow the shape of a spanner, occupying the whole length of the esophagus. Emergency rigid esophagoscopy was performed to save the patient's life.

DISCUSSION: The patient swallowed the largest hard foreign body to harm himself or his family, to get the attention of his family, or as a suicide attempt. Such patients require urgent intervention by rigid esophagoscopy to reduce the risk of complications and to save the patients' lives. Further follow-up is essential due to the possibility of repeated foreign body ingestion.

CONCLUSION: While taking care of psychiatric patients, close observation by family members is mandatory to prevent them from harming themselves and to prevent suicide attempts by swallowing sharp, hard, large, and dangerous foreign bodies such as the size 17 wrench spanner observed in the present case. © 2020 The Author(s)

Language: en

Keywords

Adult; adult; human; male; resuscitation; case report; prison; sleep; mortality; knowledge; suicide attempt; Self-injurious behavior; morbidity; mental disease; clinical article; priority journal; emergency ward; pathology; ingestion; follow up; hypersalivation; hemodynamics; restlessness; irritability; esophagoscopy; Foreign body; gastrointestinal disease; endotracheal intubation; anesthesia; airway obstruction; esophagus injury; esophagus foreign body; thorax radiography; Esophagus; swallowing; Article; visual hallucination; arterial pressure; Psychiatric patient; aphonia