Surgical management of intentional ingestion of two nail clippers in an incarcerated adult: a case report.

INTRODUCTION

Foreign body (FB) ingestion is a frequent concern in emergency settings. Intentional ingestion of FBs in adults is more common among incarcerated individuals. Complications such as impaction, perforation, hemorrhage, and obstruction may arise, necessitating prompt evaluation.

CASE PRESENTATION: We report a case of a 26-year-old incarcerated male who presented to the emergency department after ingesting two nail clippers simultaneously. He complained of epigastric pain. Plain abdominal radiography revealed two objects in the stomach. Given the sharp nature of the FBs, his symptoms, and the risk of complications, a contrast-enhanced CT scan was performed, showing no additional findings. Endoscopic retrieval was unsuccessful, and he subsequently underwent open gastrostomy, which successfully removed the objects. Postoperative recovery was uneventful.

DISCUSSION: Most gastrointestinal FBs pass spontaneously without intervention. However, outcomes differ significantly in incarcerated populations. Clinical presentation ranges from asymptomatic cases to acute abdomen. Management is challenging due to the variable size, shape, and sharpness of ingested objects. Abdominal radiography remains the first-line diagnostic tool. Treatment may include observation, endoscopic removal, or surgical intervention, depending on the clinical context. Although many FBs pass spontaneously or are retrieved endoscopically, some require surgery. Gastrostomy is widely accepted for the surgical removal of ingested FBs.

CONCLUSIONS

Incarcerated individuals represent a unique clinical population in which intentional FB ingestion reflects complex behavioral patterns, posing therapeutic challenges and a high risk of recurrence. Delayed diagnosis may lead to serious complications. Psychiatric evaluation and preventive measures are essential to reduce recurrence in incarcerated patients.