LOST TV ANTENNA DISCOVERED TOGETHER WITH A FORGOTTEN NAIL

Aims:

Ingestion of foreign bodies is commonly encountered in clinical practice involving, mainly paediatric populations. Our aim is to report an unusual case of ingestion of two sizeable metal objects, in an asymptomatic adult prisoner.

Methods:

A 50-year-old male prison inmate with a history of previous suicide attempts was admitted to the hospital after ingestion of an unknown metal object. The patient was asymptomatic with unremarkable clinical examination and laboratory tests. A plain abdominal x-ray showed 2 radiopaque objects, the larger one in the mid-abdomen and the other in the right iliac fossa (Figs. 1, 2) without any signs of perforation. Upper gastrointestinal endoscopy was performed; a metal object was identified lying on the greater gastric curvature and was retrieved using rat-tooth forceps without any complications. Re-inspection with the gastroscope revealed no bleeding or trauma.

Results:

Macroscopic examination showed a 14-cm length TV antenna that was bent in half (Fig. 3). The other foreign body was actually a nail that the patient – after initially denying it – revealed that he had ingested one year ago. Although ingestion of foreign body is uncommon in adults, it occurs more frequently in patients with psychiatric disorders, intellectual impairment, alcohol abuse, or prison inmates. Most objects pass through the GI tract spontaneously, but in some cases endoscopic or surgical removal is necessary. Endoscopic removal is a relatively safe procedure with low rates of complications. Abdominal films prior to endoscopy may allow spotting additional foreign bodies ingestion, especially in patients who have a high likelihood to withhold information.

Conclusions:

The ingestion of a foreign body into the GI tract can be a clinically serious condition with associated risks of morbidity and mortality. A thorough work-up before endoscopic interventions is important, in order to follow the appropriate therapeutic approach.