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Intentional Foreign Body Ingestions: A Complex, Recurrent and Costly Issue
1Department of Internal Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA.
The American Journal of Case Reports
|November 15, 2021
Summary
Recurrent intentional foreign body ingestion is a significant challenge, particularly in incarcerated individuals with psychiatric disorders. Interdisciplinary collaboration and environmental/therapeutic interventions are key to preventing repeat ingestions.
Area of Science:
- Gastroenterology
- Psychiatry
- Forensic Medicine
Background:
- Recurrent intentional foreign body (RIFB) ingestion presents a complex clinical and economic challenge.
- Key risk factors include male sex, incarceration, and co-occurring psychiatric disorders.
- Current literature on preventative strategies for RIFB ingestion remains limited.
Observation:
- A case report details a 23-year-old male patient with multiple psychiatric diagnoses and a history of incarceration.
- The patient experienced 6 admissions in one year for RIFB ingestion, undergoing 9 endoscopic procedures to retrieve 64 objects.
- Management involved endoscopy, observation, serial imaging, and a polyethylene glycol bowel regimen, avoiding surgery.
Findings:
- The patient's RIFB ingestions may be linked to compulsive behaviors and familial stress.
- Endoscopic retrieval and conservative management were effective in this case.
- Mean length of stay was 4.17 days per admission.
Implications:
- Interdisciplinary collaboration is crucial for effective treatment planning and recurrence reduction.
- Preventative strategies may include environmental object removal, specialized correctional units, early psychiatric intervention, and limiting hospital admissions.
- Further research is necessary to establish optimal management and prevention protocols for RIFB ingestion.
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