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This is an image series showing the various stages of the removal of foreign bodies via a midline laparotomy. The patient, who suffered from a psychiatric illness consumed the objects over a period of three months. An upper midline laparotomy was performed revealing perforation at the oseophageal-gastric junction and a subphrenic abcess associated with a nail within the stomach. The perforation was repaired and the antrum of the stomach opened to deliver another nail and plastic bottle top from within. Two drains were placed at the time of closure. The patient had an uneventful recovery and was discharged eight days post-op.
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Image (A) - Abdominal radiograph of the ingested foreign bodies. Image (B) - Midline laparotomy and localisation of foreign bodies. Images (C & D) - Delivery of the first foreign body - a nail. Image (E) - Delivery of the second foreign body - another nail. Image (F) - Delivery of the third foreign body - a bottle top. Image (G) - Abdominal closure with drains in-situ. Image (H) - The three removed foreign bodies.