Endoscopic removal of a large intragastric foreign body with an overtube: a case report.

After amphetamine ingestion, a 39-year-old male attempted suicide by swallowing glass trifles, cigarette lighter and razor blades. All foreign bodies ingested were evacuated spontaneously and smoothly within one week, except for the 10-cm long lighter, which was removed by endoscopy via supplementary overtube with moderate difficulty. The subsequent clinical course was uncomplicated. More than 80% of the ingested foreign bodies which reach the stomach can be eliminated uneventfully through the gastrointestinal tract. The remainder may cause complications such as obstruction, perforation and hemorrhage. Usually the locations of obstruction are over the three anatomic narrowings of the esophagus, the pyloric ring and ileocecal valve. Perforation occurs with ingestion of long, sharp, metallic pointed objects or animal bones, and is more frequent among those who had previous abdominal surgery or intestinal diseases. Endoscopic removal as soon as possible is suggested for high risk groups, with use of the overtube method to prevent complications.