Ingestion of foreign bodies by young patients with borderline personality disorder

Eight cases of young female patients with borderline personality disorder are reported. They presented between twice and 38 times for endoscopic extraction of ingested foreign bodies from the upper gastrointestinal tract. Thus, within a 3-year-period 265 foreign bodies were recovered at 143 endoscopies. Most frequently, spoon-handles of different lengths and broken fragments of china were extracted. Foreign bodies were almost always removed successfully and without complication. Only one knife firmly trapped between gastric fundus and antrum required a surgical gastrotomy. Depending on the type, size and number of the foreign bodies, the anticipated complexity of the endoscopic procedure and the reported fasting period approximately 40 percent of endoscopies were performed under airway protection by tracheal intubation. Despite considerable personal and material expenses most gastroenterologists, psychiatrists and surgeons advocate repeated foreign body extraction even in view of repetitive ingestion.