IMAGES IN EMERGENCY MEDICINE
Unusual human rights protest
Department of Emergency Medicine, Guys & St Thomas Hospital, London, UK
Correspondence to:
Correspondence to Dr T Jaiganesh, Emergency Department, St George's Hospital, Blackshaw Road, London SW17 0QT, UK; jaiganesh@doctors.org.uk
Accepted 29 May 2008
| The first 150 words of the full text of this article appear below. |
An intoxicated 40-year-old man presented to the emergency department having swallowed a toothbrush to "protest for human rights". He was retching and vomiting small flecks of blood. Examination was unremarkable. A chest radiograph revealed a swallowed toothbrush in the oesophagus with the bristle end seen proximally at the T4 level. He underwent rigid oesophagoscopy to remove the toothbrush and was assessed by the psychiatrist before discharge.
Approximately 45 cases of toothbrush ingestion have been reported since 1988.1 It is more common in women affected by bulimia or anorexia nervosa. Toothbrushes are characteristically seen on radiography as parallel rows of short metallic radiodensities (fig 1) due to the metallic staples that fasten the bristles in place.2 The plastic portion of the toothbrush is not visible radiographically because it is of water density. Endoscopic removal is usually performed urgently to prevent pressure necrosis which can lead to gastritis, ulceration and
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