Intentional ingestion of a full-length table fork and multiple razor blades requiring combined enterotomy and gastrotomy: a case report

Intentional ingestion of sharp foreign bodies in adults is uncommon and often associated with self-harm behavior. Multiple sharp objects located in different gastrointestinal segments significantly increase the risk of perforation and bleeding. We report a 27-year-old man who intentionally ingested nine razor blades and a full-length metallic fork. Radiography demonstrated multiple radiopaque objects without free air. Non-contrast computed tomography revealed a 185-mm fork extending from the distal esophagus into the stomach and razor blades within the proximal small bowel. Given the length of the fork, the multiplicity of sharp objects, and their distribution beyond the pylorus, endoscopic retrieval was deemed unsafe. The patient underwent urgent exploratory laparotomy with combined enterotomy and gastrotomy, enabling complete removal under intraoperative fluoroscopic guidance. Recovery was uneventful, and psychiatric follow-up was arranged. This case highlights the importance of early imaging, timely surgical intervention, and multidisciplinary care in managing complex sharp foreign body ingestion.