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Swallowed pen still works 25 years later

The pen is said to be mightier than the sword. But an unusual case report has shown that a pen may be mightier than stomach acid.

The case, which appeared in the British Medical Journal Case Reports, described a 76- year-old British woman sent to a GI specialist because of weight loss and diarrhea.

She was diagnosed with severe diverticulosis, a condition that's common in older people in which small pouches bulge out from the colon. But when doctors did a scanning test of her belly they noticed something strange: "A linear foreign body in the stomach." (Click here for photos.)

When asked about it, the woman remembered accidentally swallowing a black felt-tip pen 25 years earlier. (In case you're wondering, dentures and toothpicks are two of the most common items that adults accidentally swallow.)

According to her gastroenterologist Dr. Oliver Waters, who authored the case report, she was standing on her stairs using an uncapped pen to poke a spot on her tonsils. She was also holding a hand mirror to guide the pen to the exact spot. Somehow, while doing this, she lost her balance and stumbled. The fall managed to push the pen down her throat. It glided down her gullet and found a home in her tummy.

She told her husband and her doctor what had happened, but they were skeptical of the story. X-rays done at the time were normal and found no trace of the pen. Flash forward to the present, to a different doctor and even better stomach-scanning technology to investigate the case of the missing marker. More than two decades later a scan hit pay dirt: The pen.

Although the woman's current digestive problems had nothing to do with the marker she had unintentionally downed, doctors decided to remove it anyway. Their rationale was a case in the medical literature of a child accidentally swallowing a ball-point pen that bore a hole in his bowel. Incredibly, the pen had stayed in her stomach for 25 years without causing any significant damage to her GI tract, Waters says.

After bathing in stomach acid for a two-and-a-half decades, the pen was corroded and the plastic was flaky, but, amazingly, the pen still had usable ink and could write!

"This case highlights that plain abdominal x-rays may not identify ingested plastic objects and occasionally it may be worth believing the patient's account however unlikely it may be," the report advises doctors.

Write on!