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Case of the Month 03/10

Question 1: This 32 year old male presented to the ED complaining of abdominal pain. What's wrong with this picture? (if you’re really stuck, look at the other images below from various other ED visits.)

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Answer 1:

There is a foreign body (with the appearance of a pen) overlying the left upper abdomen (circled below). This patient had previously swallowed the handle of a broken spoon (and perforated his bowel doing so), a potato, a pencil, and a knife (see the image with the horizontal foreign body above). During the most recent visit, the two pens (last image above) were removed from the stomach by GI in the ED.