Plastic bread-bag clips in the gastrointestinal tract: report of 5 cases and review of the literature

PLASTIC BREAD-BAG CLIPS HAVE BEEN IDENTIFIED as a cause of local perforatio n or obstruction at many sites in the gastrointestinal tract. This study is the largest case series yet reported, consisting of 3 cases presenting as small-bowel perforation, 1 case in which the clip was found incidentally in the small bowel at laparotomy during vascular surgery and 1 case in which the clip was found incidentally in the small bowel at autopsy. In all cases there was no radiographic evidence to suggest a foreign body in the gastro intestinal tract. People older than 60 years of age who have either partial or full dentures seem to be particularly at risk for the accidental ingest ion of these devices. If accidentally ingested, plastic bread-bag clips rep resent a significant health hazard. As the population ages, small-bowel per foration secondary to ingestion of such clips may occur with increasing fre quency. The authors recommend elimination or redesign of the clips, to prev ent their being swallowed and becoming impacted in the small bowel or to al low them to be identified in the gastrointestinal tract by conventional rad iography.