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Metalophagia: Splenic artery pseudoaneurysm after foreign body ingestion and retrieval.

ABSTRACT: Persistent eating of non-nutritive, nonfood substances (Pica) is seen in children and adult patients with psychiatric problems. Ingestion of multiple metallic FBs with resultant bezoar formation is rare. While many FBs are passed without complication, mucosal injury, bleeding, obstruction or perforation can occur in some cases. Endoscopic FB removal is performed in 20% of patients following FB ingestion. Generally, these are safe procedures, and very effective in extracting ingested FBs. We report, a 25-year-old male patient with a metal ingestion predominant Pica, requiring multiple prior extraction procedures (including open gastrostomy). He developed a splenic artery pseudoaneurysm following his latest endoscopic FB removal, that was successfully treated with transarterial coil embolization. The unique circumstances leading to this rare complication and its successful endovascular management make this case worthy of report.

SUBMITTER: Marjara J

PROVIDER: S-EPMC7280363 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Metalophagia: Splenic artery pseudoaneurysm after foreign body ingestion and retrieval.

Marjara Jasraj J Al Juboori Alhareth A Aggarwal Arpit A Davis Ryan M RM Bhat Ambarish P AP

Radiology case reports 20200605 8

Persistent eating of non-nutritive, nonfood substances (Pica) is seen in children and adult patients with psychiatric problems. Ingestion of multiple metallic FBs with resultant bezoar formation is rare. While many FBs are passed without complication, mucosal injury, bleeding, obstruction or perforation can occur in some cases. Endoscopic FB removal is performed in 20% of patients following FB ingestion. Generally, these are safe procedures, and very effective in extracting ingested FBs. We repo ...[more]

PMID: 32528603

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Project description:Introduction Intentional and accidental foreign body ingestion are commonly encountered in clinical practice. In adults, intentional foreign body ingestion is frequently observed among individuals with psychiatric disorders and prisoners. Controversies exist regarding the management of sharp or pointed objects. We contribute to this existing controversy by presenting a case of a 43-year-old male who accidently ingested a metallic screw and was managed successfully through endoscopic retrieval. Case presentation We discuss a case of a 43-year-old male presented to our emergency department after accidently swallowing a metallic screw, 1 h and a half prior to his presentation. He was initially asymptomatic then started to complain of vague abdominal symptoms. X-rays of the chest and abdomen demonstrated the presence of a metallic screw at the mid-abdomen. Computed tomography scan of the abdomen then confirmed its presence within the gastric lumen, with no evidence of gastric or bowel perforation. The patient was managed via esophagogastroduodenoscopy in which the ingested screw was extracted. He was discharged after 24 hours in a good condition. Clinical discussion A limited number of epidemiological studies have shed light on the prevalence and incidence of foreign body ingestion among adult individuals. Probability of spontaneous passage depends on several factors including the size, shape and composition of the impacted item, as well as the age of patient and duration of ingestion prior to presentation. Conclusion Considering the variation of ingested objects and the availability of several therapeutic approaches, a patient-tailored management plan should always be established. Highlights • Metallic item ingestion represents a challenge to healthcare practitioners.• Probability of spontaneous passage depends on several factors including patient-related and item-related characteristics.• Benefit-risk assessment can help in establishing a safe yet cost-effective management plan.

Dataset Information

Metalophagia: Splenic artery pseudoaneurysm after foreign body ingestion and retrieval.

Publications

Metalophagia: Splenic artery pseudoaneurysm after foreign body ingestion and retrieval.

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