Unusual Case of Foreign-body Ingestion

Published:September 17, 2012DOI:
      A 19-year-old man with no significant medical history presented to the Emergency Department after swallowing a spoon incidentally. He had a recent 3-day history of sore throat and dry cough without shortness of breath, fever, or chills. While using a teaspoon as a tongue depressor, he experienced a strong gag reflex pulling the spoon involuntarily into the oropharynx then more distally into the gastrointestinal tract. After the ingestion, he had mild nausea, but denied any vomiting, abdominal pain, or discomfort. Laboratory work-up revealed normal complete blood count and chemistry. Two-view abdominal X-ray study revealed a 16-cm radiopaque spoon overlying the distal body and gastric antrum of the stomach, which was mildly distended with air and fluid. There was a moderate amount of intraluminal fecal debris in the colon. However, there was no free air or fluid seen (Figure 1, Figure 2). He is a successful college student who denied any history of medical or psychiatric disease, including pica or depression. He denied taking any medication and his family history was negative for any relevant diseases.
      Figure thumbnail gr1
      Figure 1AP abdominal X-ray view revealing a 16-cm radiopaque spoon overlying the distal body and gastric antrum of the stomach, which was mildly distended with air and fluid. There was a moderate amount of intraluminal fecal debris in the colon.
      Figure thumbnail gr2
      Figure 2Lateral X-ray view revealing the radiopaque spoon in the distal stomach portion.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Schunk J.E.
        • Harrison A.M.
        • Corneli H.M.
        • Nixon G.W.
        Fluoroscopic Foley catheter removal of esophageal foreign bodies in children: experience with 415 episodes.
        Pediatrics. 1994; 94: 709-714
        • Webb W.A.
        Management of foreign bodies of the upper gastrointestinal tract: update.
        Gastrointest Endosc. 1995; 41: 39-51
        • Vizcarrondo F.J.
        • Brady P.G.
        • Nord H.J.
        Foreign bodies of the upper gastrointestinal tract.
        Gastrointest Endosc. 1983; 29: 208-210
        • Pellerin D.
        • Fortier-Beaulieu M.
        • Guegen J.
        The fate of swallowed foreign bodies: Experience of 1250 instances of subdiaphragmatic foreign bodies in children.
        Program Pediatr Radiol. 1969; 2: 302
        • Palta R.
        • Sahota A.
        • Bemarki A.
        • et al.
        Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion.
        Gastrointest Endosc. 2009; 69: 426-433
        • Weiland S.T.
        • Schurr M.J.
        Conservative management of ingested foreign bodies.
        J Gastrointest Surg. 2002; 6: 496-500
        • Sung S.H.
        • Jeon S.W.
        • Son H.S.
        • et al.
        Factors predictive of risk for complications in patients with oesophageal foreign bodies.
        Dig Liver Dis. 2011; 43: 632-635
        • Li Z.S.
        • Sun Z.X.
        • Zou D.W.
        • et al.
        Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China.
        Gastrointest Endosc. 2006; 64: 485-492
        • Desai T.K.
        • Stecevic V.
        • Chang C.H.
        • et al.
        Association of eosinophilic inflammation with esophageal food impaction in adults.
        Gastrointest Endosc. 2005; 61: 795-801
        • Kirberg A.E.
        Long-standing esophageal foreign body.
        Gastrointest Endosc. 1986; 32: 304-305
        • Khan M.A.
        • Hameed A.
        • Choudhry A.J.
        Management of foreign bodies in the esophagus.
        J Coll Physicians Surg Pak. 2004; 14: 218-220
        • Ghahremani G.G.
        Foreign bodies of the alimentary tract.
        in: Gore R.M. Levine M.S. Laufer I. Textbook of Gastrointestinal Radiology. WB Saunders, Philadelphia1994: 2547
        • Ikenberry S.O.
        • Jue T.L.
        • et al.
        • ASGE Standards of Practice Committee
        Management of ingested foreign bodies and food impactions.
        Gastrointest Endosc. 2011; 73: 1085-1091
        • Eisen G.M.
        • Baron T.H.
        • Dominitz J.A.
        • et al.
        Guideline for the management of ingested foreign bodies.
        Gastrointest Endosc. 2002; 55: 802-806
        • Yardeni D.
        • Yardeni H.
        • Coran A.G.
        • Golladay E.S.
        Severe esophageal damage due to button battery ingestion: can it be prevented?.
        Pediatr Surg Int. 2004; 20: 496-501
        • Bryant A.S.
        • Cerfolio R.J.
        Esophageal trauma.
        Thorac Surg Clin. 2007; 17: 63-72