Colonoscopy Removes Eight Nails Lodged in Woman’s Intestines
A 30-year-old patient underwent surgery after swallowing eight metal nails that traveled deep into her lower digestive tract, threatening to puncture her organs. According to a medical report published in BMJ Case Reports, the woman sought hospital treatment following severe stomach pain. Medical personnel discovered that she had a history of pica—a psychological disorder defined by the compulsive ingestion of inedible items—alongside an underlying anxiety disorder. Dr. Bhoowit Lerttiendamrong from the University of Connecticut School of Medicine noted in the case documentation that this marked the patient’s sixth episode of foreign body ingestion over the preceding year.
Scans track nails moving toward the ileocaecal valve
Upon admission, the clinical team initially opted for conservative observation to see if the sharp objects would pass through the digestive system naturally. The patient underwent abdominal scans every 12 hours to track the objects’ trajectory. Serial imaging revealed that multiple nails had migrated from her upper abdomen down through the mid-abdomen. Eventually, the items clustered near the ileocaecal valve, which is the sphincter muscle separating the small intestine from the large intestine. After four days without further spontaneous movement, physicians decided active intervention was necessary to prevent potential organ perforation.
Cap-Assisted Colonoscopy Procedure
Medical staff performed a specialized cap-assisted colonoscopy, attaching a small, transparent cap to the tip of the endoscope to improve visibility and control. Doctors successfully extracted all eight metal nails using this technique. Subsequent examinations revealed that the patient sustained only superficial abrasions along the intestinal lining. Commenting on the unusual nature of the case, Dr. Lerttiendamrong stated that it is rare for a swallowed foreign body—let alone a sharp one—to travel that far down into the lower gastrointestinal system.
Patient refuses inpatient care and recovers after one year
Following the procedure, hospital staff consulted the psychiatry department regarding the patient’s ongoing mental health care needs. Although psychiatric teams recommended inpatient admission, the patient adamantly refused and declined to stay in the psychiatric unit. One year after the colonoscopy, outpatient follow-up evaluations confirmed that the patient has experienced no further complications related to the incident.
What is pica and its primary symptoms?
What is pica and what are its primary symptoms?
Pica is a mental health disorder characterized by the compulsive eating of non-food items such as stones, coins, shampoo, and metal objects. While some objects pass without incident, the condition carries severe risks including gut blockages, poisoning, and internal organ perforation.
Why are swallowed nails particularly dangerous for the digestive tract?
Sharp and irregular metal objects like nails carry a high risk of puncturing the walls of the stomach or intestines. This perforation can cause digestive fluids and bacteria to leak into the abdomen, potentially leading to severe internal bleeding, infections, or life-threatening sepsis.
How common is the ingestion of foreign objects in psychiatric patients?
Intentional foreign body ingestion frequently occurs in individuals with psychiatric conditions, developmental delays, or during periods of incarceration. While approximately 80 percent of ingested objects pass spontaneously, sharp items often require endoscopic or surgical removal.
Keep reading