EMERGENCY CASEBOOK
Cardiac tamponade due to ingested gastric foreign body
Digestive Diseases Unit & Cardiothoracic Unit, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
Correspondence to:
Correspondence to:
MrD Manifold
Digestive Diseases Unit, Level 9a, Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK; donald.manifold@bsuh.nhs.uk
Accepted 20 August 2006
| The first 150 words of the full text of this article appear below. |
Ingestion of foreign bodies is a well-recognised problem in children and adults with psychiatric conditions and personality disorders.1 Patients may be asymptomatic or may present with symptoms and signs of gastrointestinal obstruction, perforation and/or bleeding. A rare case of an ingested foreign body in the stomach causing pericardial tamponade is described here.
A 24-year-old woman with a history of personality disorder, borderline schizophrenia and alcohol abuse was an inpatient in a psychiatric hospital. She had a history of acts of deliberate self-harm including foreign body ingestion. She had ingested a plastic ball point pen 5 weeks earlier and was being managed conservatively. She was referred to the emergency department with increasing epigastric pain and general malaise. On examination, she was found to be febrile (38°C) and clinically shocked. Cardiac auscultation revealed a third heart sound. Abdominal examination revealed mild epigastric tenderness but no peritonitis. Laboratory tests showed a leucocytosis (38.5
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