Clinical and x-ray justification of Exner's reflex significance in case of sharp ingested foreign bodies in the gastrointestinal tract: clinical case report

Sharp ingested foreign bodies in the digestive tract are quite a rare find in the clinical practice of urgent abdominal surgery. Such cases are more likely to be found among mental, observed in mentally ill patients, prisoners, elderly and drug addicts. Accidental cases are actually quite seldom. Sharp foreign bodies are mainly ingested on purpose due to the changed mental state. However, this does not make them any less dangerous. The way the objects pass through the digestive tract strongly depends on their size and characteristics. The passage becomes slightly easier when a foreign body goes through the stomach. Most cases with a basic (uncomplicated) passage are insympathetic, which makes them very difficult to diagnose. According to Exner's reflex, sharp foreign bodies within the gut can travel freely, without any damage to the gastrointestinal tract by inhibiting the contractions of the overlaying muscle so that perforation will be avoided. The sharp edges of the foreign body irritate the mucous membrane causing the tightening of the mucous. That makes the object turn gradually to present its blunt edges, provided that the length of the object does not exceed the lumen of the intestine. The clinical observation shows the manifestation of the ‘needle’ reflex described by Exner in 1902, which allowed us to dispense with surgery and avoid complications, which in many cases are fatal.