Bread clip ingestion resulting in small bowel perforation: A case report

Abstract

Bread clip ingestion is an avoidable, all too common cause of an acute surgical abdomen. Patients present with various symptoms ranging from dysphagia, bleeding, perforation, and death with few cases successfully passing without causing significant damage. The patient in this case had gastrointestinal symptoms for over 2 months with associated weight loss, mimicking a time length of malignancy. The clip was lodged in the small bowel, which is often the case. This study presents an uncommon presentation of symptoms with evidence of the varying degrees of bread clip injury, preceding perforation. Plastic resists enzymatic breakdown in the gastrointestinal tract, and its unique shape contributes to the bowel wall getting caught in between its jaws, followed by dislodgment through peristalsis, and eventual perforation. Despite publicity in Australian news articles, manufacturers and supermarkets still utilize products with plastic bread clips and present an avoidable health hazard to patients in this country.