Swallowed Foreign Objects Cost $2M at RI Hospital

John Commins, for HealthLeaders Media , November 3, 2010

"Our study shows that intentional ingestion of foreign bodies is a relatively common event at our hospital. Intentional, rather than accidental, swallowing is a poorly recognized and underappreciated problem which is potentially avoidable," Moss said. 

Moss said 58% of the patients were male, and the mean age for the patients at the time of ingestion was 35. One patient was responsible for 67 of the 305 cases, and four patients accounted for 179 cases. Fifty-three percent of the patients were admitted from residential institutions, mostly from a state-run chronic psychiatric inpatient facility. Thirty-eight percent of the patients were from private homes, and 9% were from prison.

More than half of the patients were diagnosed with a mood disorder, while others suffered from anxiety, substance abuse, psychotic or impulse control disorders.

"The reasons for foreign body ingestion vary and it is one of many forms of self-injurious behavior. Foreign body ingestion can be a behavioral element of cognitive disorders, mental retardation syndromes, psychotic disorders, and mood disorders," said co-author Colin Harrington, MD, a psychiatrist at RIH. "Various personality disorder diagnoses are also associated with foreign body ingestion where motivations are thought to include communication of internal distress, acting out due to anger, or even manipulation of the environment with a related secondary gain, such as transfer out of chronic institutional settings like prison or long-term treatment facilities."

Harrington said most cases of foreign object ingestion do not represent suicide attempts and that "repetitive foreign body ingestion occurs in a very small group of patients and is typically difficult to treat and prevent."

John Commins is a senior editor with HealthLeaders Media.

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