Acuphagia: Insights into a rare surgical emergency

Abstract

Acuphagia, the intentional ingestion of sharp metallic objects, is a high-risk form of pica associated with significant morbidity, including perforation, bleeding, and sepsis. This case series highlights key clinical lessons: a high index of suspicion is required due to unreliable histories, and imaging is essential for diagnosis and monitoring of multiple or migrating foreign bodies. Management must be individualised, ranging from conservative observation to endoscopic or surgical intervention depending on presentation. Recurrent ingestion and underlying psychiatric disease are common, necessitating early multidisciplinary involvement. In resource-limited settings, delays in presentation further increase the risk of complications, underscoring the need for structured diagnostic pathways and coordinated care.