The Management of Voluntary Ingestion of Razor Blades by Inmates

Abstract

Introduction: Ingestion of sharp objects is a rare event. We report our experience in the care of prisoners who ingested razor blades as well as the in-time evolution of our management. Material and Methods: This is a descriptive study including all detainees ingesting razor blade, transferred from the prison to Farhat Hached University Hospital of Sousse, from January first,2014 to December 31st ,2015. Thus, we have counted 19 cases of swallowed razor blades in 16 prisoners; indeed, one prisoner had ingested a razor blade thrice and another had ingested a blade twice. Results: Our study includes 19 episodes of swallowed razor blades. In two cases, these events were secondary to suicide attempts. In the other cases, it was an expression of discontent and rejection of the situation in the prison. Three patients had a psychiatric history. The mean age of patients is 24 years. The initial clinical examination had not objectified signs of gastrointestinal perforation. Thoraco-abdomino-pelvic CT had allowed specifying the blade location in all cases. It had objectified, also, a pneumo-mediastinum in two cases. The blade location was esophageal in one case, gastric in six cases and in the small bowel in the other cases. The first four patients had surgical removal of the blade. In subsequent cases, the surgical abstention was the rule, and the spontaneous blade expulsion was observed. The average time of expulsion was four days. Conclusion: In our experience, surgical removal of the sharp foreign bodies should not be performed systematically without complications.

Ingestion of A Sharp Foreign Body by an Infant

“…6 Overviews on FB ingestion are plentiful, but the ingestion of sharp objects, especially in pediatric patients, is rarely discussed, and guidelines regarding definitive management are infrequent. Generally, such ingestions reveal a variety of underlying intentional or unintentional reasons, but studies on sharps ingestion in adults establish a common presentation amongst prisoners 7 or patients with significant psychiatric comorbidities. 8 Multiple symptoms of varying severity have been attributed to FB ingestion depending upon its location.…”

Sharp Object in the Belly: A Case of Pediatric Intentional Razor Blade Ingestion in the Emergency Department

“…Prior literature has not demonstrated any consistent examination findings in suspected ingestions, although cases of perforation may reveal mediastinal emphysema and/or peritoneal signs with significant pain, tenderness, and a rigid abdomen depending on the FOB location [4,5]. Diagnosis for razor blade ingestion is typically made on plain film radiographs, as the metallic material is radiopaque and can be reasonably correlated with the position in the gastrointestinal tract, although one case series utilized computed tomography for more precise localization [8]. Additional evaluation can include hemoglobin and hematocrit counts, as well as fecal occult blood testing, if bleeding is suspected.…”