Hidden dangers of sliced bread.

Three cases of an unusual foreign body in small bowel

“…Previously reported cases have come to attention because the ingestion of the clip has been complicated by mucosal ulceration, perforation, obstruction, intussusception, fistula formation, or abdominal abscess necessitating surgery in all, and serving as a background for postoperative death in 3 [5][6][7][8]. The 3 patients reported here had the clips recovered incidentally when other disease processes interrupted their clinical courses.…”

“…The nature of these clips apparently makes them more likely to be held up in the gastrointestinal tract (most of the reports in the literature are of small bowel attachment of the clip although in occasional cases clips have caught in the esophagus [5][6][7][8]). In all cases the mechanism of attachment is similar.…”

“…If the full thickness of the wall is trapped, perforation or stricture may occur [5][6][7]. If the clip is released back into the lumen of the intestine it may reattach at a new site, and the process repeat itself, resulting in multiple mucosal ulcerations [5]. In other cases, while the claws may grasp one wall, the clip's free edge may erode the opposite wall [7].…”

The dangers of the bread clip – CT imaging and management: a case report

“…It appears to be a relatively frequent finding that patients do not remember swallowing the bread clip. [4,5] In the scant literature on this particular subject, the problem seems to arise mainly in patients over the age of 60 years and in patients with dental prostheses (like the patient in this case report). [1] An earlier case report demonstrated that a long period of time can pass between ingestion of the bread clip and the occurrence of an intestinal perforation: Tang et al described a patient with a perforation due to a bread clip swallowed two and a half years earlier.…”

“…[1] An earlier case report demonstrated that a long period of time can pass between ingestion of the bread clip and the occurrence of an intestinal perforation: Tang et al described a patient with a perforation due to a bread clip swallowed two and a half years earlier. [5] Of course, not all foreign objects cause intestinal perforations. The shape of the bread clip is thought to be the most important factor in developing such complications.…”