Dear Naveen,

Those files are not very long but quite thin and pointy and being made of metal are radiopaque, right? I would follow the very good published guidance by the American Society for Gastrointestinal Endoscopy (ASGE) on sharp pointed objects:

Establish first that the instrument is not lodged in the oesophagus and that it has not passed beyond the stomach by radiological evaluation. If it is lodged in the oesophagus, its removal is an absolute emergency. If it has not passed beyond proximal duodenum remove endoscopically, as there is still a 35 % chance of complications by letting a small sharp object pass via its natural way. Otherwise careful observation with serial xrays and consider surgical intervention if the object has failed to be passed within three days. Warn patient/carer/family to immediately report abdominal pain, fever, vomiting, haematemesis melaena or pr bleeding.

http://www.asge.org/uploadedFiles/Publications_and_Products/Practice_Guidelines/Management%20of%20ingested%20foreign%20bodies%20and%20food%20impactions.pdf

Best wishes,

Immo

Thank you Dr Immo Weichert for this valuable information.

Long ago I worked as a contract physician for the local juvenile detention center. We once had an epidemic of young men swallowing broken razor blades, which got them out of the detention facility and special care until our treatment changed to a simple in facility radiograph to confirm the segment was not in the esophagus and a diet of oatmeal until the segment was returned. The epidemic ended.

Dear Naveen,

Accidentally swallowed files should be removed as early as possible. and i agree with explanation given by Immo Weichert.

Thank you Dr Nirmala.

Thank you Dr Alonzo H Jones.