Replacing plastic bread clips with cardboard will prevent bowel perforation

Abstract

Plastic bread clips cause significant morbidity and mortality if accidentally ingested. A review of all existing case reports published in medical literature was conducted in PubMed, MedLine and Google Scholar. Key words included but was not limited to; clip, tag, tab, closure, kwik lok, bread, bag, ingestion, bowel, obstruction, perforation, plastic and foreign body. References of all the articles were sought out to ensure completeness. Fifty-six cases between 1975 and 2020 were analysed to understand the complications and the characteristics of the bread clip that caused these. About 28% of case reports described bowel perforation, with 61% of these occurring in the small bowel. Plastic bread clips are firm in nature, long lasting, and are shaped to grasp onto bowel, thus leading to these complications. Commercially available alternatives are introduced in order to encourage replacing plastic bread clips worldwide.

Bread clip ingestion resulting in small bowel perforation: A case report

“…The cause of pathology from bread clip ingestion is owing to its unique shape of jaws that clamp to bowel wall and bowel collects in the jaws, dislodges, and ulcerates, until bowel wall entrenches in the clip, and perforates [5,6] . The composition of plastic also resists enzyme and acid breakdown [7,8]. Liew et al described a case of bread clip ingestion causing impaction in the colon.…”