Ingestion of Metallic Materials Found in the Stomach and First Part of the Duodenum of a Schizophrenic Man: Case Report

INTRODUCTION: Foreign body ingestion causes a serious health problems like bleeding, abscess formation, septicemia, perforation, and obstruction of the esophagus, stomach and the intestine. In adults, foreign body ingestion is more common in the elderly, individuals with mental illness or who have an intellectual disability, alcohol poisoning, prison inmates, and drug traffickers. CASE PRESENTATION: We present a 22 year old male patient who presented with abdominal distension and vomiting of ingested matter of two to three episodes per day of one month duration. He is a known schizophrenic patient for the past three years and has been on follow up at a nearby hospital. He swallowed metallic nails in an attempt to kill himself. On abdominal examination there was distension, and epigastric tenderness. His plain abdominal x-ray showed multiple radiopaque foreign body in the stomach. Similarly, abdominal ultrasound showed thickened gastric wall and multiple linear foreign bodies in the stomach. Then, with the impression of gastric outlet obstruction secondary to foreign body in the stomach, laparotomy plus gastrotomy plus foreign body removal and repair were done under general anesthesia. Dilated stomach, palpable mass on distal stomach and first part of duodenum, and adhesion between stomach, abdominal wall and liver was found intra operatively. CONCLUSION: Passage of curved metal through the throat is a rare case. Mentally ill individuals need close follow up and physiological consultation.