The cutting edge: a 17-year-old female with razor blade inge
A 17-year-old female presented to the Emergency Department after reporting the ingestion of multiple razor blades. She endorsed sharp abdominal pain and had epigastric abdominal tenderness without rebound or guarding. Abdominal x-ray revealed many rectangular, high-density objects projecting over the left abdomen without evidence of obstruction or perforation (Figure 1). The patient underwent urgent esophagogastroduodenoscopy. Multiple safety blades were noted in the stomach with abrasions throughout the distal esophagus and stomach (Figure 2). Given their unusual shape, attempts to remove the razors using an overtube were unsuccessful. Removal of all razors using raptor forceps grasped on one end and an endoscopic protector hood, without further injury to the mucosa post-procedure. The patient was discharged the following day with psychiatry follow-up.

NASPGHAN guidelines for foreign body removal recommend that sharp objects in the stomach be removed urgently to prevent complications. An endoscopic overtube facilitates the removal of sharp-edged objects, protecting the gastrointestinal mucosa from injury. Modifications of the overtube have been made to accommodate unusually shaped objects, but not all objects may be able to fit inside an overtube despite modifications. This case uniquely illustrates the clinical challenges that can be faced with ingested sharp foreign bodies.

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