(Forthcoming posts under the title above will all involve strange and sensational subjects. Given my blogging performance past it is safe to say the series will consist of at least one entry).
The Ingestion of Foreign Objects
Children often swallow small objects and adults sometimes accidentally ingest things that were not meant to sink into the stomach, if indeed they can get that far. As well, there are people who deliberately swallow items - many, many items.
I happened to stumble across a short article in The TImes (London) from the early 1980s that offered examples of patients who had, on purpose, put into their mouths many things not remotely related to any of the major food groups. That article prompted a reader to send in a clipping from The Times which provided another example that occurred almost 50 years earlier. In that piece there was another reference to an even earlier article that was supposedly found in the New York Times and it had to do with a woman who was found to have half a hardware store in her stomach.
If you are at all interested in investigative reporting involving gastric issues read on since I was able to track down all the sources. Although some of the accounts are astonishing, keep in mind that the sources are a medical journal and the two TIMES, and that his all happened before the era of fake news.
A Knife and Fork For Dinner
The original report that started all of this is found in the “Times Diary” for March 1, 1982 under the heading “Hard to Swallow”. The author is summarizing an article from a medical journal. I went looking for the original source and here it is: “Recognition and Management of Patients who Repeatedly Swallow Foreign Bodies”, Journal of the Royal Society of Medicine, Volume 75, February 1982. The article notes that “During 1978, over 3000 operations for the removal of foreign bodies from-the gastrointestinal tract were performed on adults in England and Wales”.
Here are the five cases presented in that article (if you wish, you can skip these medical accounts and go directly to the two sensational journalistic ones that follow):
Case reports
Case 1:
An 18-year-old warehouseman in Cardiff docks, with a history of repeated drug overdosage, was first treated in the Midlands in 1965 by gastrotomy for the removal of an ingested darning needle. Eleven years after this he swallowed some razor blades which he had wrapped in tissue paper. These were removed at laparotomy which was complicated by a faecal fistula. A few weeks later, following a quarrel with his prostitute girlfriend, he swallowed some more razor blades which, again, he had covered with tissue paper 'so as not to cut my throat'. A plain anteroposterior abdominal X-ray (Figure 1) showed a razor blade which, although it overlay the gastric shadow, was not seen in the stomach at gastroscopy because it was probably situated in the transverse colon. The blades passed naturally and without complication.[WOW]
Case 2:
A male cook first presented at a hospital on the south coast, aged 23, after he had swallowed some pins. Following an unsuccessful attempt at endoscopic removal, the pins were removed by gastrotomy which was complicated by a subphrenic abscess. Two years later he swallowed several darning needles which on plain abdominal X-ray appeared to lie outside the bowel (Figure 2). There were no physical signs to suggest bowel perforation and he was therefore managed conservatively, without complication. Two weeks later he swallowed a propelling pencil and a kitchen knife which both passed naturally. Six months after this he swallowed a penknife and an open safety pin. The penknife was removed at gastrotomy but the safety pin could not be found, and was subsequently passed naturally. When the patient was told that he was fit for discharge, he threatened to 'swallow the hospital bit by bit'; as an hors d'oeuvre he promptly swallowed a bolt from the bed-elevating mechanism. A month after discharge he attended the accident and emergency department of another London hospital claiming falsely to have swallowed paraquat. Two weeks after this he was readmitted to Charing Cross Hospital following an overdose of chlorpromazine, amitriptyline and salbutamol. While an inpatient he swallowed an open safety pin which passed naturally, and a few days before discharge, using a syringe which he had acquired on the ward, he injected his anterior abdominal wall with lavatory cleaner.
Case 3.
A divorced woman, aged 28, was seen at a hospital in Surrey having swallowed three spoons. There was a previous history of depressive illness in adolescence, which had been treated by electroconvulsive therapy, and she had cut her wrists at the age of 23. The patient said that she had swallowed the spoons because she heard a voice telling her to do so. During the next fifteen years, in response to this voice, she swallowed safety pins, needles, hair grips, a tooth brush, both metal and plastic teaspoons, over a dozen dessert spoons and the bell end of a stethoscope. She has undergone at least 17 laparotomies, in a variety of hospitals, for the
removal of these objects. At one laparotomy performed in Charing Cross Hospital, five spoons marked 'Guy's Hospital' were removed. The indications for each of the laparotomies varied but at no time had bowel perforation occurred. Although there are at least five spoons at present in her bowel (Figure 3), for the past three years a policy of conservative management has been adhered to. She has remained well during this period, although she has been admitted to Charing Cross Hospital on four occasions with mild intestinal obstruction which has rapidly settled with a period of intravenous fluids and nasogastric decompression. It is not clear whether this obstruction is the result of previous surgical adhesions or is due to the spoons.
Case 4.
A 17-year-old subnormal boy, in long-term hospital care, presented with
haematemesis. Plain abdominal X-ray demonstrated foreign bodies in the stomach, including nails, razor blades, glass and coins. Endoscopic removal was attempted but was unsuccessful and the objects were removed by gastrotomy. Following this operation the patient developed mediastinal abscesses which were the result of an oesophageal tear at the level of the azygos arch and which required a thoracotomy for drainage.
Case 5.
A 17-year-old reform school boy swallowed several nuts and bolts because he 'felt like a change of scenery'. He was admitted to St Woolos' Hospital, Newport, where he was managed conservatively and returned to his school's sick-bay. Eventually he was able to confirm, from regular stool examination, that all the objects seen on the plain abdominal Xray had been passed.
“Heimlich Maneuver Sprays Shrapnel”
Had these next two accounts appeared in the tabloids, they might have had a title like the one above.
The clipping sent in by The Times’s reader must have been this article:
“Italian Labourer’s Appetite: A Diet of Mixed Hardware,” The Times, Sept. 19, 1936.
This report is from their correspondent in Trieste.
“An X-ray examination in a local hospital revealed in the stomach of a 47-year-old labourer 11 pencils, three fountain pens, a fork, a screw, several coins and five keys. Two more pencils had been painfully ejected by the patient as he was entering the hospital, but his statement that he was unable to go home because he had swallowed the key of the front door was disbelieved until its probability was scientifically proved.
A glimpse of other undefined articles, equally hard of digestion, lying in his stomach was obtained, but a complete inventory of them was obtained only on Wednesday after an intricate operation, the fruits of which are said to have amazed the surgeon who performed it. One by one were taken from the man’s body 13 ordinary keys, a large door key, a screw, a sardine-tin opener, three cigarette holders, a spoon, 15 pencils, five fountain pens, four penknives, a safety razor holder, two needles, a piece of glass, four 2-lire coins, one 50-centesimi coin, and a key chain. The operation is said to have been perfectly successful, and the man’s first words after its conclusion were to inquire whether the 8,50 lire he had swallowed had been found.
In the reporting about the 1936 account provided above there was a reference to a sensational case two years earlier and this would be it. Given that we are all now more sensitive about medical privacy I almost redacted Miss Wolf’s name, but I am pretty sure she is not around to be offended. This report is from The New York Times, March 20, 1934.
“1,2O3 METAL ITEMS EATEN BY WOMAN: Hardware Found in Stomach Includes Bolts, Screws, Tacks, Pins, Wire and Glass -SWALLOWED FIVE YEARS AGO”.
A total of 1,203 items of hardware was taken from the stomach of a woman patient at Kings County Hospital after an operation last week, Dr. Adam Eberle, superintendent of the institution, revealed yesterday.
The patient, Miss Mabel Wolf, 40 years old, of 476 Eastern Parkway, Brooklyn, is recovering and apparently will be none the worse for the experience. Dr. Eberle said her immediate need was a prolonged rest and a more orthodox diet.
The operation, for which the original diagnosis was gall bladder trouble, was performed last Tuesday by Dr. Anthony Pirundini under the direction of Dr. Edwin H. Fiske, head of the hospital’s surgical staff.
The list of items removed follows:
584 fine upholstery tacks,
144 carpet tacks,
2 chair tacks,
46 small screws,
6 mediums screws,
80 large screws,
1 hook-shaped screw (coat hanger)
30 small bolts,
47 larger bolts,
3 picture-frame hooks,
3 nuts,
2 large bent safety pins,
1 small safety pin,
1 head of nail,
3 brass nails,
83 pins,
9 pins without heads,
1 matted mass of hair containing screws and pins.
59 assorted beads,
4 pieces of wire,
89 pieces of glass (all sizes),
1 piece of teacup handle.
According to the story she told physicians, Miss Wolf swallowed the objects in the course of a single week five years ago when she was employed in the hardware section of a Manhattan department store. She said she felt depressed one day and for reasons which she cannot account, swallowed a quantity of tacks, nails, screws and pins.
This she continued for the next five days. There were no immediate effects, she said, but a few weeks later she began to have recurrent pains. These she treated successfully with patent medicines until a few weeks ago, when they became so acute she called a physician.
She was taken to the hospital, where an X-ray examination revealed a mass of foreign substance in the stomach. The physicians were frankly puzzled, but even more so after the operation was performed. They are at a loss to explain how she was able to retain the metal objects for so long a period of time.
Dr. Eberle said the case had attracted a great deal of attention at the hospital and that the hardware had been placed on exhibition for the benefit of internes and others interested.
Miss Wolf is understood to live alone and have no relatives.
You will have to admit that this subject is more interesting than "Clean Eating" and are probably relieved that the entire article was gluten-free.
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