“Press-through package”-induced colon hemorrhage

Abstract

A 80-year-old woman was admitted because of abdominal pain. On the third day of admission, she had bloody stool with increasing abdominal pain. Colonoscopy revealed that a press-through package (PTP) was lodged in the sigmoid colon and ulcers were present adjacent to sharp edge. The package was removed by endoscopic forceps and the patient was discharged in good capsules. PTPs are rapidly becoming popular as packages for tablets and capsules. Reports of accidental swallowing of a PTP have been increasing but progression of PTPs to the colon is rare. We were able to remove it endoscopically. We propose that drugs should not be dispended in PTPs especially to elderly patients. It is also important to inform patients that accidental swallowing of PTPs is disastrus and warn them not to swallow PTPs. Collaboration of co-medical staff such as a pharmacist is necessary.