A case of a wayward bread bag clip: an unusual cause of intestinal ulceration

Abstract

Accidental ingestion of foreign objects is not uncommon. Often these objects pass through the intestinal system without any sig-nificant complications. They can cause a degree of abdominal discomfort or vomiting but are likely to pass without further intervention. Rarely, they may lead to more serious complications such as ulceration, perforation and even death. We received a short segment of small bowel in our laboratory with the clinical history of ‘foreign body in a possible strictured area’. Macroscopically the bowel wall appeared focally thickened and firm. No obvious foreign body was seen and there was no perforation. Microscopically, there was fibrosis and unusual linear ulcers that were relatively well demarcated. This was associated with suppurative inflamma-tion and adjacent necrosis. Additional clinical history was sought and the radiology reviewed. Reconstructed images showed a plastic bread clip within the bowel. A literature search reveals at least 26 cases reported of bread bag clip ingestion causing varying degrees of intestinal complications. We discuss some of the common features and the histological appearance and postulate that perhaps with our increasing aging population the ubiquitous bread bag clip should be considered in patients with suspected foreign body in-gestion.