A 30-year-old woman underwent an unusual medical procedure after swallowing eight metal nails that became lodged near the junction of her small and large intestines, raising concerns that the sharp objects could tear or perforate her bowel.
The woman was admitted to hospital with severe abdominal pain and was already receiving psychiatric care. According to a case report published in BMJ Case Reports, she had a history of repeatedly swallowing foreign objects and had experienced six such episodes within a year.
Doctors initially monitored her condition, hoping the nails would move through her digestive system naturally. However, after four days with little progress, the medical team decided to remove them using a specialised colonoscopy technique.
All eight nails were successfully retrieved, and doctors reported that the woman suffered only superficial abrasions to the intestinal lining. The case was published in BMJ Case Reports in September 2026.
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1. Woman Had Swallowed Objects Six Times in One Year
The woman had a history of recurrent foreign-body ingestion and was receiving psychiatric care for conditions that included pica and anxiety.
Pica is a condition involving persistent cravings for, or consumption of, non-food substances such as metal, paper, soil or other materials that have no nutritional value.
According to the medical report, swallowing the eight nails was her sixth episode of foreign-body ingestion in the preceding 12 months.
The repeated incidents presented a significant medical challenge because swallowed objects can cause intestinal obstruction, internal injuries or poisoning, depending on the material and where it becomes lodged.
Pica can occur alongside certain mental health conditions, developmental conditions or nutritional deficiencies, although its causes vary between individuals.
Healthdirect Australia provides further information about the condition, its potential complications and available treatment approaches in its guide to pica.
2. Doctors Feared the Sharp Nails Could Damage Her Intestines
When the woman arrived at hospital with severe abdominal pain, doctors were concerned that the metal nails could pierce the walls of her digestive tract.
Sharp objects can be particularly dangerous when swallowed because they may injure surrounding tissue as they travel through the gastrointestinal system.
Although many swallowed foreign objects pass naturally, sharp-pointed items require careful medical assessment. Their location, shape, size and movement through the digestive tract all influence how doctors manage the situation.
The medical team initially chose close observation rather than immediate removal. The woman underwent imaging examinations every 12 hours so doctors could monitor the nails’ progress and check whether they were moving through the intestines.
The scans showed that the objects were gradually moving from the middle of the abdomen towards the lower-right region.
However, the nails eventually clustered near the ileocaecal valve, the junction between the small intestine and the large intestine.
3. Four Days of Monitoring Led to a Specialised Colonoscopy
After four days of limited movement, doctors decided that continuing to wait carried sufficient risks to justify intervention.
Rather than performing conventional open surgery, the team used a colonoscopy to retrieve the nails from the lower gastrointestinal tract.
A colonoscopy involves passing a flexible instrument with a camera through the rectum to examine the large intestine. It can also allow doctors to carry out certain procedures, including the removal of foreign objects in suitable circumstances.
In this case, the medical team used a specialised technique involving a transparent cap attached to the end of the colonoscope. The cap helped the doctors control the sharp objects during extraction and protect the surrounding intestinal lining.
The procedure was particularly unusual because foreign-body removal is more commonly performed in the upper digestive tract. Objects that travel as far as the lower intestine can be harder to retrieve safely.
The doctors successfully removed all eight nails.
4. The Nails Caused Only Superficial Intestinal Injuries
Despite concerns that the nails could perforate the bowel, the woman avoided the most serious feared complication.
The case report described superficial abrasions to the intestinal lining, indicating that the sharp objects had caused limited surface injuries rather than a reported full-thickness perforation.
The medical team reported no further complications following the colonoscopy.
The successful outcome highlights the importance of assessing the location of swallowed objects and choosing an appropriate removal method. It does not mean that swallowing nails or other sharp items is generally safe, nor that colonoscopy is suitable for every case.
The doctors emphasised the difficulty of managing sharp foreign bodies because their irregular shapes can make them challenging to grasp and remove.
The case also illustrates why repeated imaging and specialist assessment may be necessary when objects become lodged in the digestive tract.
5. Woman Declined Recommended Psychiatric Admission
Following the procedure, the hospital’s psychiatry department was consulted because of the woman’s history of repeated foreign-body ingestion.
According to the case report, the psychiatric team recommended that she be admitted for further care, but she firmly declined inpatient treatment.
She was subsequently followed up as an outpatient, and the report recorded no further complications following the colonoscopy.
The case highlights an important challenge in treating recurrent pica: removing swallowed objects may address the immediate physical danger, but longer-term care may also be needed to help reduce the risk of recurrence.
Depending on the individual, treatment can involve psychological support, behavioural therapy, assessment for nutritional deficiencies and care for any associated medical or psychiatric conditions.
The appropriate approach depends on the person’s circumstances and should be determined by qualified healthcare professionals.
What Is Pica, and When Should Someone Seek Help?
Pica involves repeatedly eating substances that are not food. While the behaviour can have different underlying causes, consuming non-food objects can lead to choking, poisoning, intestinal blockage or internal injuries.
Anyone who repeatedly craves or eats non-food items should speak with a healthcare professional for an assessment. Medical teams may investigate possible nutritional deficiencies and assess whether psychological or behavioural support would be helpful.
Swallowing nails or another sharp object requires urgent medical assessment, even if there are no immediate symptoms. Anyone in that situation should seek emergency medical care rather than waiting for the object to pass or attempting to remove it at home.
The case of the 30-year-old woman demonstrates how a rare and potentially dangerous medical emergency was managed successfully, while also underlining the importance of addressing the underlying behaviour as part of longer-term care.
