SHM Converge Scientific Abstract ePoster Gallery-Accidental Foreign Body Ingestion

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An 85-year-old woman with systolic heart failure, prior stroke, persistent atrial fibrillation, and a recent myocardial infarction with drug-eluting stent presented with 4 days of abdominal pain, vomiting, anorexia, and inability to tolerate oral intake. She had recently increased her pill burden, including multiple supplements. Exam showed mild right lower quadrant tenderness without peritoneal signs. Labs were unremarkable, but CT abdomen/pelvis demonstrated small bowel obstruction with a small radiopaque intraluminal mass. She was initially thought to have a pill bezoar and improved briefly with conservative management, but she later failed diet advancement. Repeat CT showed persistent obstruction at the level of the radiodense object with concern for small bowel pneumatosis. She underwent urgent exploratory laparotomy, which revealed and removed a foreign body identified as a desiccant cylinder commonly found in pill bottles.<br /><br />Her postoperative course was prolonged by pain, nausea, and poor oral intake, requiring TPN and enteral tube feeds. She was eventually discharged with close follow-up and instructions to stop several supplements.<br /><br />This case highlights that accidental foreign body ingestion is not just a pediatric issue. In older adults, risk factors include impaired swallowing, reduced oral sensation, poor vision, and denture use. Common ingested objects include fish or chicken bones, dental prostheses, and medication packaging. Foreign bodies in the lower GI tract may pass spontaneously, but can also cause small bowel obstruction. Delayed diagnosis and removal increase the risk of serious complications, underscoring the need for high clinical suspicion in elderly patients with obstructive symptoms.

Asset Subtitle

Claire Sevov

Meta Tag

Author List Claire Sevov, Julia Turner

Category Clinical Vignettes

Concept Foreign Body Ingestion

Concept Bowel Obstruction

Concept Older Adults

Concept Small Bowel Obstruction

Concept Intraluminal Foreign Body

Distinguished Non-Finalist

Presenter Organization The Ohio State University College of Medicine

Presenting Author Claire Sevov

Track Adult

Keywords

small bowel obstruction

foreign body ingestion

elderly patient

desiccant cylinder

pill bezoar

abdominal pain

exploratory laparotomy

pneumatosis

drug-eluting stent

atrial fibrillation

Foreign Body Ingestion

Bowel Obstruction

Older Adults

Small Bowel Obstruction

Intraluminal Foreign Body