Clinical Image - International Journal of Clinical & Medical Images (2017) Volume 4, Issue 2
Author(s): Guragai N, Kollimuttahullam S and Mukaddam S
Clinical Image: A 37-year-old male with known case of paranoid schizophrenia presented to our emergency department after he inserted 2 pencils into his penis leading to pain and bleeding. Patient had significant history with multiple attempts of self harm by ingesting sharp objects, batteries, sleeping pills and cutting his wrist. He underwent cystoscopic removal with Foley catheter placement and his symptoms gradually resolved in few days. His hospital course was complicated on fourth day of admission as he apparently ate electric glass light bulb from the bathroom with intent of secondary gain. Initial X-ray abdomen showed numerous scattered radio- opaque foreign bodies in the entire colon (Figure 1). Computed tomography of chest and abdomen didn’t reveal perforation. Patient was kept NPO and observed clinically with serial abdominal examination. Follow-up serial X-ray abdomen was done which showed gradual clearing of radio opaque foreign bodies until day 11 when all the foreign body was completely cleared (Figure 2). Patient didn’t have any symptoms and there were no signs of peritonitis or bowel perforation during the entire hospital stay. The patient was eventually discharged from the hospital. Foreign body ingestion is encountered commonly in clinical practice . Most ingested foreign bodies pass spontaneously. However few cases of foreign body ingestion require endoscopic removal or surgery to treat complications. Even though the risk of a complication caused by a sharp-pointed object is as high as 35%, but these patients could be observed clinically provided there are no symptoms or signs of perforation.