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Sharp Object in the Belly: A Case of Pediatric Intentional Razor Blade Ingestion in the Emergency Department
Brandon M Carius1, P M Dodge2, Brit Long3
1Emergency Medicine, Brian D. Allgood Army Community Hospital, Camp Humphreys, KOR.
Insights
Foreign object ingestion, particularly sharp items like razor blades, requires careful management. Most cases of sharp foreign object ingestion can be managed non-interventionally with close monitoring for natural passage.
Area of Science:
- Gastroenterology
- Emergency Medicine
- Radiology
Background:
- Ingested foreign objects (FOBs) are common in emergency departments, especially in children.
- Sharp FOBs, such as razor blades, pose a significant risk of gastrointestinal perforation.
- Ingestion of razor blades often occurs in vulnerable populations, complicating diagnosis and management.
Observation:
- A 17-year-old female presented with suspected foreign object ingestion.
- Abdominal radiography revealed a 3.0 x 0.5 cm razor blade.
- Initial evaluation was unremarkable prior to radiographic findings.
Findings:
- Literature suggests a high risk of perforation with sharp FOBs.
- Limited research supports a non-interventional strategy for most sharp FOB ingestions.
- Close follow-up and serial radiographs are recommended for natural passage.
Implications:
- Surgical consultation recommended conservative management with serial radiographs.
- The patient was discharged with instructions for a bulk food diet.
- This case supports a strategy of non-interventional management for select sharp foreign object ingestions.
Abstract:
Ingested foreign object (FOB) is a common complaint in the emergency department (ED), especially in pediatric patients. While many FOB ingestions are benign, sharp objects, including razor blades, are of particular concern given the acute risk of perforation throughout the gastrointestinal tracts. The majority of razor blade ingestions involve prisoners and psychiatric patients, which can complicate the diagnosis and treatment. Although literature suggests that risks of perforation and complication may be high, limited research available on sharp FOB ingestions supports a general non-interventional strategy. Instead, close follow-up and serial radiographs for natural passage are recommended for the majority of cases. We highlight the case of a 17-year-old female who presented to the ED for suspected FOB ingestion and was found to have a singular 3.0 x 0.5 cm razor blade on abdominal radiograph following an unremarkable initial evaluation. In line with prior literature, surgical consult supported natural passage with serial radiographs, and the patient was subsequently discharged home with a recommended bulk food diet.
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