TL;DR
Get self-care and calm essentials delivered free — and shop member deals
- Fast, free delivery on millions of items
- Access to Prime Big Deal Days deals on October 6–7
- Prime Video, Amazon Music and more included
Doctors used cap-assisted colonoscopy to remove eight nails from the colon of a woman in her 30s after the objects stopped moving near the ileocecal valve. The case report says the procedure caused only minor superficial abrasions, but the authors stress that sharp-object removal carries a significant perforation risk and requires experienced endoscopists and surgical backup.
Doctors removed eight nails from the colon of a woman in her 30s using a cap-assisted colonoscopy, after the objects clustered near the ileocecal valve and did not pass during four days of observation. The case, reported in BMJ Case Reports, describes a way clinicians may retrieve sharp objects lodged in the lower digestive tract, while emphasizing the risk of perforation and the need for specialist care.
The woman came to medical attention with persistent abdominal pain after intentionally swallowing multiple nails. The report says she had a history of foreign-body ingestion, pica disorder and anxiety disorder, and that this was her sixth episode in a year. The clinicians initially managed her without an operation, using bowel rest, polyethylene glycol and abdominal X-rays every 12 hours to track the objects.
Imaging showed the nails moving from the middle of the abdomen to the right lower quadrant, where they gathered near the point at which the small intestine joins the large intestine. After four days without passage, doctors proceeded with colonoscopy. They attached a short, transparent cap to the end of the scope and used a snare to remove each nail, taking care to keep the sharp ends under the cap.
The authors reported that all eight nails were retrieved and that inspection found minor superficial abrasions to the colon lining. The report says the patient had no further complications one year later and was being followed as an outpatient. Psychiatry was consulted during her care; according to the case report, the team recommended admission, but the patient refused.
A Lower-GI Option With Risks
The case illustrates a potential endoscopic option when sharp objects have moved beyond the stomach and become lodged in the colon. Nails can be difficult to grasp because of their sharp, irregular shape, and an object can injure or perforate the digestive tract. Retrieval decisions depend on the patient’s condition, the location of the object and whether it continues to move.
The authors described the cap as a way to shield the colon lining while the objects are handled. But this is a single case report, not evidence that the approach is appropriate for every patient. The report’s authors said the technique should be used by experienced endoscopists, with surgical backup available, because perforation is a significant risk both before and during the procedure.
As an affiliate, we earn on qualifying purchases.
How Clinicians Managed the Nails
Many swallowed foreign objects pass through the digestive system without a procedure. The case report notes that about 80% of ingested foreign bodies pass spontaneously. It also says endoscopic retrieval may be considered when conservative management does not work or when a sharp object raises concern about injury. That general figure does not predict what will happen in an individual case.
In this patient’s case, clinicians first monitored the nails rather than trying to retrieve them while their position was less suitable for endoscopy. Serial X-rays tracked their movement; after they clustered near the ileocecal valve and remained there without passing, the team chose colonoscopy. The authors noted that published reports of removing foreign objects from the lower gastrointestinal tract are limited.
Cap-assisted endoscopy uses a short polymer tube on the scope’s tip. The report explains that caps are also used in colonoscopy to reduce blind spots and help protect the lining during procedures. Here, doctors used the cap to cover the nail tips as they drew the objects out, but the authors cautioned that the cap itself can cause trauma and may make it harder to advance the scope through a tortuous colon.
“It’s pretty rare to have a foreign body that goes all the way down to the lower GI system, and even rarer that sharp foreign bodies go down that far.”
— Bhoowit Lerttiendamrong, MD, of the University of Connecticut School of Medicine, speaking to MedPage Today
As an affiliate, we earn on qualifying purchases.
Limits of a Single Case
The report does not establish how often cap-assisted colonoscopy succeeds or how its risks compare with surgery or other approaches. Lerttiendamrong told MedPage Today that the procedure is not widely proven and that there is no specific guideline for these cases. The case also cannot show whether similar outcomes would occur in patients with different anatomy, object locations or signs of injury.
The authors identified practical concerns: a cap can make scope advancement challenging, particularly in a difficult or tortuous colon, and may itself injure the lining. They framed the technique for clinically stable patients without evidence of perforation or peritonitis, with surgical support readily available. The report does not provide evidence to broaden that scope.
As an affiliate, we earn on qualifying purchases.
Follow-Up and Clinical Evidence
The report says the patient had no further complications at one year and continued outpatient follow-up. It does not describe a planned additional procedure or a new guideline arising from the case. The case authors’ immediate conclusion is limited: cap-assisted colonoscopy may be useful in selected, stable patients when performed by experienced endoscopists and with surgical backup available.
For clinicians, further published cases and research would be needed to clarify when this approach is appropriate and how its risks compare with alternatives. In any individual incident involving swallowed sharp objects, management depends on clinical assessment; this case report is not a substitute for medical care.
As an affiliate, we earn on qualifying purchases.
Key Questions
How many nails did doctors remove?
Doctors retrieved eight nails using a snare during cap-assisted colonoscopy, according to the case report.
Where were the nails lodged?
They had clustered near the ileocecal valve, where the small intestine meets the large intestine.
Why did the doctors use a cap on the colonoscope?
The team used a transparent cap at the end of the scope to help shield the colon lining from the nails’ sharp ends during retrieval.
Was the procedure risk-free?
No. The case report describes only minor superficial abrasions in this patient, but its authors warn that perforation is a significant risk and say the procedure should be done by experienced endoscopists with surgical backup.
How was the patient doing later?
The report says she had no further complications one year later and was receiving outpatient follow-up.
Source: rss
Halloween Picks
halloween
As an affiliate, we earn on qualifying purchases.
