Abdominal foreign body: nail

Case contributed by Christoph Berliner


Whilst cleaning an interdental space two days ago and walking down the stairs the patient accidentally swallowed a used nail. No abdominal pain.

Patient Data

Age: 30 years
Gender: Male

Passage of an abdominal foreign body (nail) through the GI tract:

Initial abdominal x-ray: The nail is located in the terminal ileum. An ultrasound shows no signs of free air or fluid.

Two days later the nail has passed into the proximal cecum. Again no signs of perforation on an ultrasound examination.

Another 48 hours later (144 hours after ingestion) the nail has passed into the distal sigmoid / proximal rectum. Still no signs of perforation on an ultrasound.

Another 24 hours later (1 week total since initial ingestion) the foreign body has been spontaneously expelled per rectum.

Case Discussion

Accidentally swallowed radiopaque foreign bodies are a quite common finding on x-rays. 

Luckily even sharp objects passing the esophagus do not tend to perforate the bowel so that besides object extraction there is the option of natural passage.

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