Unusual gastrointestinal foreign bodies: A case series highlighting diverse presentations and endoscopic management

Foreign body insertion and ingestion are commonly encountered emergencies in clinical practice. Although most foreign bodies pass spontaneously or can be removed endoscopically, unusual cases present significant diagnostic and therapeutic challenges. We describe four rare cases of foreign body insertion managed at a tertiary care center, highlighting diagnostic approaches, endoscopic techniques, and outcomes. This case series includes four patients with unusual foreign body insertions: (1) accidental ingestion of a toothbrush, (2) gossypiboma eroding into the gastrointestinal tract, (3) rectal insertion of a plastic bottle, and (4) esophageal misplacement of an endotracheal tube. Clinical features, imaging findings, endoscopic interventions, and outcomes were analyzed. A 17-year-old boy with cerebral palsy accidentally ingested a toothbrush, which was successfully retrieved endoscopically from the antrum using a snare. A 45-year-old man presented with persistent vomiting following cholecystectomy and was diagnosed via imaging with a gossypiboma eroding into the gastrointestinal tract; it was successfully removed endoscopically over two sessions. A 32-year-old man with rectal insertion of a plastic bottle underwent unsuccessful endoscopic removal; the object was ultimately extracted digitally with the aid of abdominal compression. A 60-year-old woman with status epilepticus had an endotracheal tube misplaced into the esophagus and stomach, which was detected by imaging and removed endoscopically using a snare. All four patients recovered without complications, and none required surgical intervention. Unusual foreign body insertions require individualized assessment and a multidisciplinary approach. Prompt imaging, innovative endoscopic techniques, and procedural adaptability are essential for successful, minimally invasive retrieval. These rare cases underscore the importance of clinical vigilance, especially in postoperative contexts or patients with neurological impairment, and highlight the necessity of training in prehospital airway management to prevent iatrogenic complications.