Spontaneous passage of accidentally ingested metallic nail in an adult: A case report

Foreign body ingestion is most common in children, as well as adults with neurodevelopmental and psychiatric problems. The most commonly swallowed foreign bodies in adults include fish bones, chicken bones, toothpicks, and dentures. Sharp and elongated ones are the most typical causes of gastrointestinal perforation among the aforementioned. In about 1% of cases, foreign bodies are known to remain lodged within the bowel and cause luminal erosion and perforation.

A 23-year-old male construction laborer presented to the Emergency Surgical Unit of Debre Markos Hospital 7 h after he accidentally swallowed a nail while at work. He didn't have abdominal pain, vomiting, or rectal bleeding. On exams his vital signs were stable. His chest and abdominal exams as well as the digital rectal examination were unremarkable. He was evaluated with a plain erect abdominal x-ray based on his complaint, which revealed a long nail lying longitudinally in the right lower quadrant of the abdomen. Twenty-nine hours after swallowing the iron nail, he passed it through his rectum spontaneously.

Plain radiography should be performed to locate and follow-up on radiopaque foreign entities before sophisticated imaging and invasive procedures. When treating people who have accidentally ingested a sharp foreign body, clinicians should find a balance between prompt action and careful follow-up.