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Unusual Case of Foreign-body Ingestion

Published:September 17, 2012DOI:https://doi.org/10.1016/j.jemermed.2012.07.065
      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.
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