Foreign body ingestions in a schizophrenic patient

The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and involves subtleties in evaluation and management not usually seen in accidental ingestions. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions ofthis type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid.