This is a case report of foreign body ingestion in a suicide attempt resulting in gastric perforation and phlegmon formation during a subsequent 6 month period that eventually required surgical intervention. The patient had a prolonged course because she did not report a history of foreign body ingestion and the initial evaluating physicians had no suspicion about possible foreign body ingestion and may have missed important findings on physical examination. Gastric perforation by a foreign object may have a slow course rather than presenting acute abdomen. The realization of a proper physical examination in the emergency department is key to an accurate diagnosis.
Rao V, Sarkar R, Turner R, Wedgwood K. Unusual presentation of gastric perforation by foreign body: a case report. Case Rep Surg. 2011;2011:1-2.
Goh BK, Chow PK, Quah H-M, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg. 2006;30(3):372-7.
Lam PY, Marks M, Fink A, Oliver M, Woodward A. Delayed presentation of an ingested foreign body causing gastric perforation. J Paediatr Child Health. 2001;37(3):303-4.
Mehran A, Podkameni D, Rosenthal R, Szomstein S. Gastric perforation secondary to ingestion of a sharp foreign body. JSLS. 2005;9(1):91-3.
Steenvoorde P, Moues CM, Viersma JH. Gastric perforation due to the ingestion of a hollow toothpick: report of a case. Surg Today. 2002;32(8):731-3.