Three Canterbury men ended up in hospital over a three-month period with the same unusual problem — all had accidentally swallowed beer bottle caps during sessions of heavy drinking.
Warning: This story contains graphic images.
A recent article in the New Zealand Medical Journal analysed the cases. It delved into how the caps were swallowed by the men and how they were removed.
All three men ended up in the Christchurch Hospital emergency room after accidentally ingesting the metal caps. None of the men were connected or known to each other, and none of them remembered how the caps ended up inside them.
It said ingesting bottle caps was “rare as a phenomenon” but could be “life-threatening owing to their sharp edges".
Since all the men couldn’t remember swallowing the caps, the article's authors - Asim Abdulhamid, Heidi Yi-han Su and Steven Leslie Ding - suspected “that ingestion took place during the rapid consumption of excess amounts of alcohol, with or without the soporific, anaesthetic effect of antecedent inebriation".
The first case discussed was a man 30-year-old man who checked into the hospital with a complete acute oesophageal obstruction.
After a chest x-ray, medical staff attempted to remove the cap with a roth net, an endoscopic retrieval device, but failed. It needed to be pulled out with an extraction hood and a scope. The man was left with a minor oesophageal erosion.
The second man, a 38-year-old, went to the hospital after experiencing pain two days after accidentally swallowing a bottlecap.
It needed to be removed by a braided snare with heat after a roth net failed – ultimately leaving him with a gastric ulcer.
The final man, a 55-year-old, presented at the hospital suffering a complete acute oesophageal obstruction. The cap had been pushed into his stomach and was unable to be removed due to the presence of food.
It was eventually removed after a repeat endoscopy after fasting, where it was pulled out with a Roth net.
According to the article, Canterbury sees the second-highest alcohol weekly alcohol intake by region.
“The adverse consequences are realised at the hospital front door, with 4–5% of emergency department presentations relating to alcohol consumption.”
Talking about the bottle caps specifically, the article reads: “The burden of alcohol excess and pattern of drinking in Canterbury makes this presentation far from novel.”
It said the cause of the issue came entirely down to the drinking habits of adult men.
The article suggested several ways to address the accidental ingestion of bottle caps.
“Though rare as presentations, conceivable measures that may abrogate its risk include advocating for consumption of cold beer where a burgeoning “brain freeze” might slow the rate of consumption, encouraging more expensive beers as a financial disincentive, drinking alternative beverages including champagne (where there remains no case reports of oesophageal obstruction) or wine.
“At the heart of the issue, addressing the hitherto unshiftable entity of hazardous beer drinking.”
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