Objective: This case report is of a 34 year-old female with borderline personality disorder/ obsessive-compulsive disorder who presented in the Accident & Emergency (A&E) Department on repeated occasions having swallowed 121 razor blades over an eighteenmonth period.
Method: Case report. Results: Rigid oesophagoscopy was performed to remove the razor blades on each occasion. Applying the Mental Capacity Act (2005) she was found to lack the capacity to manage her treatment but the psychiatrists deemed her unsuitable for detainment under the Mental Health Act. Following frequent multidisciplinary discussions between ENT, Psychiatry and the A&E Department it was felt that removal of the foreign bodies was further escalating her behaviour and a decision was made to cease endoscopic retrieval via oesophagoscopy.
Conclusion: This case highlights the difficulties faced when managing psychiatric patients who require immediate surgical intervention. ENT surgeons need to use a multidisciplinary approach to manage these patients successfully.