Ingestion of nine metallic nails with corrosive: what happened next?

A 20-year-old woman was brought to the surgery emergency department with the complaint of epigastric pain since 1 day following ingestion of multiple metallic nails with a cup full of toilet cleaner (corrosive acid) with a suicidal intention. Physical examination was essentially unremarkable, and the abdomen showed no signs of perforation peritonitis. X-rays of the abdomen showed multiple ‘nail’-like radiopaque shadows in the abdominal cavity with no evidence of free gas under the domes of the diaphragm. A non-operative expectant management was pursued. The patient had passed all the sharps in stools without any complication and was discharged after 12 days. After 3 weeks, the patient presented with non-bilious vomiting. Further investigations revealed pyloric stenosis with no oesophageal luminal stenosis. To bypass the pyloric stenosis, a Billroth II gastrojejunostomy was performed. The postoperative period was uneventful, and the recovery was smooth.

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