Department of General Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran.
Department of Anesthesiology, School of Medicine, Pain Research center Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Islamic Republic of Iran.
J Med Case Rep. 2024 Aug 16;18(1):381. doi: 10.1186/s13256-024-04672-3.
Ingestion of foreign bodies may be seen unconsciously or intentionally in patients with mental health problems. Most cases pass through the esophagus slowly; however, in some cases, the tumor may be located in narrower areas of the digestive tract that require endoscopic or surgical intervention. This study describes a rare case of successful removal of more than 450 pieces of metal objects from the stomach of a 36-year-old man via ingestion of foreign bodies at Imam Khomeini Hospital in Ahvaz.
A 36-year-old male patient (Aryan race) presented with complaints of chronic abdominal pain, frequent vomiting, and intolerance to liquids and food. The patient's companions mentioned a history of gradual ingestion of small metal objects 3 months prior. The patient was conscious and had stable vital signs. In the patient's X-ray and endoscopy, multiple metal objects inside the patient's stomach were observed, causing gastric outlet obstruction. The patient underwent gastrostomy surgery, and 452 screws, nuts, keys, stones, and other metal parts weighing 2900 g were removed from the stomach. Five days after the operation, the patient was transferred to the psychiatric service in good general condition and was diagnosed with psychosis, and her condition returned to normal at follow-up.
Successful removal of this foreign body is rare. In chronic abdominal pain, especially in the context of psychiatric disorders, attention should be given to the ingestion of foreign bodies. In swallowing large amounts of sharp and metallic foreign objects, surgical intervention is necessary, especially in cases of obstruction, and saves the patient's life.
精神健康问题患者可能会无意识或有意识地吞下异物。大多数情况下异物会缓慢通过食管；然而，在某些情况下，肿瘤可能位于消化道较狭窄的部位，需要进行内镜或手术干预。本研究描述了在阿瓦士伊玛目霍梅尼医院，通过内镜或手术成功从一名 36 岁男性的胃中取出 450 多件金属异物的罕见病例。
一名 36 岁男性（雅利安人）因慢性腹痛、频繁呕吐以及对液体和食物不耐受而就诊。患者的同伴提到 3 个月前逐渐摄入小金属物体的病史。患者意识清醒，生命体征稳定。在患者的 X 射线和内镜检查中，观察到患者胃内有多个金属物体，导致胃出口梗阻。患者接受了胃造口术，从胃中取出了 452 颗螺丝、螺母、钥匙、石头和其他重达 2900 克的金属部件。术后 5 天，患者一般情况良好，转入精神科，诊断为精神病，随访时病情恢复正常。
成功取出这种异物的情况很少见。在慢性腹痛，特别是在精神障碍的情况下，应注意异物的摄入。在摄入大量尖锐和金属异物的情况下，需要进行手术干预，尤其是在发生梗阻的情况下，这可以挽救患者的生命。
