Recurrent Foreign Body Ingestion in a Psychiatric Patient: A Conservative Approach

Foreign body ingestion in psychiatric patients is a challenging condition, often linked to severe complications and significant morbidity. We report the case of a 33-year-old woman with bipolar affective disorder and borderline personality disorder who presented with abdominal pain, melena, vomiting, and anorexia. Imaging and endoscopy revealed multiple ingested nails. The patient had a history of four previous surgical interventions for similar episodes, resulting in extensive abdominal adhesions. After a failed endoscopic removal, conservative management was chosen, with close clinical and radiological monitoring. She was discharged after 18 days without retained foreign bodies or complications. This case highlights the importance of individualized management in psychiatric patients with recurrent foreign body ingestion. Although surgery is sometimes necessary, its risks increase with repeated laparotomies. Conservative treatment can be a safe alternative, especially when endoscopy fails. A multidisciplinary approach is essential to evaluate risks and guide the choice between invasive and non-invasive strategies for optimal outcomes.