Report an endoscopic case in which multiple emergency endoscopies were performed on a psychiatric patient due to foreign body ingestion.

Deliberately ingesting foreign objects is a relatively common phenomenon among people with substance use disorders or psychiatric conditions. When this behaviour is repeated, it may indicate a pattern of self-harm or a way of seeking relief. These patients are difficult to treat, so a coordinated multidisciplinary team must examine the biological, social and psychological needs. 

Patients with suspected or diagnosed foreign bodies in the upper digestive tract should undergo endoscopy to confirm the diagnosis and and establish the optimal treatment. The therapeutic approach to removing ingested objects varies depending on their location, nature and any associated complications. If endoscopy fails, surgery should be performed.

17-year-old female patient with a history of attachment disorder, personality disorder (cluster B) and eating disorder without substance abuse is presented. Between 2023 and the present, several healthcare visits were made by the patient due to voluntary ingestion of foreign bodies.

The first upper gastrointestinal endoscopy was performed on 24 July 2023, with the last documented procedure taking place on 20 October 2025. In total, 34 emergency endoscopies were performed due to foreign body ingestion.

Of these, 19 were performed in the Digestive Endoscopy Unit itself.  Due to the potential risk posed by the ingested foreign body, 12 endoscopies were performed in the operating theatre and one in the resuscitation room of the Emergency Department.

All endoscopies were performed under sedation and/or general anaesthesia depending on the procedure location, with only one performed while the patient was conscious.

In only 16 out of the total number of endoscopies carried out, foreign objects were observed. These objects included plastic (5) or medical supplies such as an identification bracelet or a peripheral venous extension tube and others, as well as batteries (3), a carabiner, a chess piece, a screw, and pieces of glass (3).

The procedure has not been without complications. On two occasions, ulcers were observed as a result of the presence of batteries, as well as one tear and two lacerations.

There was an irregular frequency pattern, with some dates showing repeat endoscopies on the same day or consecutive days, and others showing breaks of weeks or even months.

The nursing staff care for the patient throughout the emergency endoscopy. However, our work ends once the foreign body has been removed. The large number of endoscopies we have performed over the years has made us feel impotent, as we are unable to provide a lasting solution to the problem.

The patient is still undergoing psychiatric and psychological treatment, which is essential for her recovery.

Endoscopic treatment is only a solution for removing foreign bodies that could lead to complications. Psychological therapy, combined with medication, can help to reduce the number of voluntary ingestions by providing an explanation and treatment.