AB168. SOH21AS170. Foreign body ingestion: presenting in an unusual way

Background: This is a case report of 15 years old psychiatric girl with previous history of foreign body ingestion. She presented with very vague symptoms inconclusive for recurrent ingestion. Two ingested vinyl gloves lying in stomach were removed through gastroscopy. Special attention must be given when considering the ingestion of foreign body in the intellectually disabled population as these cases may not present classically.

Methods: Esophagogastroduodenoscopy was used to remove the foreign body i.e., two nitrile gloves.

Results: Many ingested objects pass spontaneously through the gastrointestinal tract without causing complications, intervention is required in a few. However, indications and time to proceed remain controversial. More than 90% of foreign body in oesophagus are removed spontaneously; however, a few are stuck and cannot pass the tract. Approximately, 10% of ingested foreign bodies (FBs) may remain in the gastrointestinal tract. She was reviewed by a consultant on call and the decision to take her to theatre was made. Diagnostic laparoscopy and oesophagogastroduodenoscopy (OGD) was planned. Esophagogastroduodenoscopy showed two nitrile gloves, which were removed by biopsy forceps. No damage was done while removing the foreign body despite their stiffness and deformity.

Conclusions: Vinyl gloves are malleable enough to pass through a significant portion of the gastrointestinal tract. However, the vinyl can harden and cause a significant risk of obstruction and perforation. Institutions and families that care for mentally retarded individuals, especially those patients diagnosed with pica, must strictly monitor the accessibility of vinyl gloves or find a more reasonable and safer substitute.

Keywords: PICA (psychiatric disorder); foreign body (FB); nitrile gloves; gastrointestinal tract; esophagogastroduodenoscopy