1
|
Fung BM, Sweetser S, Wong Kee Song LM, Tabibian JH. Foreign object ingestion and esophageal food impaction: An update and review on endoscopic management. World J Gastrointest Endosc 2019; 11:174-192. [PMID: 30918584 PMCID: PMC6425280 DOI: 10.4253/wjge.v11.i3.174] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 02/06/2023] Open
Abstract
Foreign body ingestion encompasses both foreign object ingestion (FOI) and esophageal food impaction (EFI) and represents a common and clinically significant scenario among patients of all ages. The immediate risk to the patient ranges from negligible to life-threatening, depending on the ingested substance, its location, patient fitness, and time to appropriate therapy. This article reviews the FOI and EFI literature and highlights important considerations and implications for pediatric and adult patients as well as their providers. Where published literature is insufficient to provide evidence-based guidance, expert opinion is included to supplement the content of this comprehensive review.
Collapse
Affiliation(s)
- Brian M Fung
- UCLA-Olive View Internal Medicine Residency Program, Sylmar, CA 91342, United States
| | - Seth Sweetser
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
| | - Louis M Wong Kee Song
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
| | - James H Tabibian
- Division of Gastroenterology, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States
| |
Collapse
|
2
|
Abstract
AIM To systemically collect and summarize the literature on case reports concerning adverse events associated with the oral use of a toothbrush. MATERIALS AND METHODS Two electronic databases were searched for articles published up to October 2013 to identify appropriate studies using focused search terms and 'case reports' as a filter. Results. A comprehensive search identified 419 unique titles and abstracts. Ninety-four studies met the eligibility criteria. In total, 118 subjects (age range = 1-60 years) presented adverse events related to the oral use of a toothbrush. Events could be summarized in five categories, of which ingestion was the most reported problem among the individuals (50 cases). This was followed by impaction of a toothbrush (27 cases). Reports more frequently involved females and children were more likely to have injuries compared to males and adults. Most of the cases that presented with adverse events of the oral use of a toothbrush were referred for treatment to a physician. CONCLUSIONS The combined evidence related to serious adverse events as presented in case reports showed that the oral use of a toothbrush can be associated with ingestion, impaction, instant trauma, gingival traumatic injury and seizures. Given the incidence of reporting, important recommendations are that a toothbrush should not be used to induce vomiting, nor should people walk or run with this device in their mouths, especially children.
Collapse
Affiliation(s)
- Sara Cioccari Oliveira
- Department of Periodontology, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam , The Netherlands
| | | | | |
Collapse
|
3
|
Jamal K, Shaunak S, Kalsi S, Nehra D. Successful laparoscopic removal of an ingested toothbrush. J Surg Tech Case Rep 2014; 5:99-102. [PMID: 24741430 PMCID: PMC3977335 DOI: 10.4103/2006-8808.128751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Most ingested foreign bodies will pass through the gastrointestinal tract without any problems. On the other hand long, slender objects such as a toothbrush will rarely be able to negotiate the angulated and fixed retroperitoneal duodenal loop. Spontaneous toothbrush passage has never been described and therefore endoscopic or surgical removal is always required. Here we describe an asymptomatic young female presenting to out-patient clinic with a history of unintentional toothbrush ingestion 4 years prior. Endoscopic removal was unsuccessful because the toothbrush was partially embedded in to the gastric mucosa. We describe the second case to date of laparoscopic removal of a toothbrush via a gastrotomy with subsequent intra-corporeal repair of the defect.
Collapse
Affiliation(s)
- Karim Jamal
- Departments of General Surgery SpR in Upper GI Surgery, Epsom and St. Helier University Hospitals NHS Trust, United Kingdom
| | - Shalin Shaunak
- CT1 in Surgery, Epsom and St. Helier University Hospitals NHS Trust, United Kingdom
| | - Sarandeep Kalsi
- Foundation Year 1 Doctor, Epsom and St. Helier University Hospitals NHS Trust, United Kingdom
| | - Dhiren Nehra
- Consultant in Upper GI Surgery, Epsom and St. Helier University Hospitals NHS Trust, United Kingdom
| |
Collapse
|
4
|
Tammana VS, Valluru N, Sanderson A. All the wrong places: an unusual case of foreign body ingestion and inhalation. Case Rep Gastroenterol 2013; 6:778-83. [PMID: 23341801 PMCID: PMC3551388 DOI: 10.1159/000346287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Intentional ingestion of foreign bodies is common in psychiatric patients and prison inmates. Timing of endoscopy for ingested foreign bodies varies and depends on the type and location of the foreign body in the gastrointestinal tract. We present the case of a 26-year-old man who was brought from a correctional facility after confessing to have swallowed a few shower curtain hooks. Abdominal X-ray done in the emergency room revealed multiple foreign bodies in the stomach. An upper endoscopy was done in the emergency room with the use of an overtube. The first metal piece was caught by a snare and removed with the endoscope. All other foreign bodies which were present on the abdominal X-ray could not be visualized initially as there was retained food in the stomach. After multiple attempts, four other foreign bodies were found and each one was caught by the forceps and then the scope was removed with the forceps holding the foreign body. There was an additional foreign body in the right mainstem bronchus. The patient had coughed up the foreign body and swallowed it into the gastrointestinal tract. A computed tomography scan of chest and abdomen was done for evaluation, which showed the foreign body in the cecum. To our knowledge, this is the first case report of a patient intentionally transferring a foreign body from one organ system to another. Colonoscopy was done and the foreign body was removed rectally with a snare without any complications.
Collapse
Affiliation(s)
- V S Tammana
- Howard University Hospital, Washington, D.C., USA
| | | | | |
Collapse
|
5
|
Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, Decker GA, Fanelli RD, Fisher LR, Fukami N, Harrison ME, Jain R, Khan KM, Krinsky ML, Maple JT, Sharaf R, Strohmeyer L, Dominitz JA. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011; 73:1085-91. [PMID: 21628009 DOI: 10.1016/j.gie.2010.11.010] [Citation(s) in RCA: 451] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2010] [Accepted: 11/05/2010] [Indexed: 02/08/2023]
|
6
|
Tonkic A, Bogdanovic Z, Grandić L. Successful endoscopic removal of a swallowed toothbrush: case report. Case Rep Gastroenterol 2011; 5:122-4. [PMID: 21512617 PMCID: PMC3080583 DOI: 10.1159/000326962] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Most ingested foreign bodies will pass uneventfully through the gastrointestinal tract. Nevertheless, long and rigid foreign bodies are associated with an increased risk of gastrointestinal impaction, perforation and bleeding. Moreover, there has been no case of spontaneous passage of a toothbrush reported. Therefore, the prompt removal of such ingested foreign objects is recommended before complications develop. This case report describes a case of an 18-year-old woman who accidentally swallowed her toothbrush. The toothbrush was successfully removed via flexible endoscopy using a polypectomy snare. A swallowed toothbrush is a special clinical challenge. Early endoscopic retrieval of the toothbrush is critical for reducing morbidity and mortality. In cases when endoscopic removal fails, a laparoscopic surgical approach may be an alternative.
Collapse
Affiliation(s)
- Ante Tonkic
- Department of Internal Medicine, Division of Gastroenterology, Split, Croatia
| | | | | |
Collapse
|
7
|
Islam SR, Islam EA, Hodges D, Nugent K, Parupudi S. Endoscopic removal of multiple duodenum foreign bodies: An unusual occurrence. World J Gastrointest Endosc 2010; 2:186-9. [PMID: 21160746 PMCID: PMC2999126 DOI: 10.4253/wjge.v2.i5.186] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 03/26/2010] [Accepted: 04/02/2010] [Indexed: 02/05/2023] Open
Abstract
Deliberate single foreign body ingestion is a scenario that many gastroenterologists commonly see in psychiatric units and prisons. However, multiple foreign body ingestions, especially located in the duodenum, provide the endoscopist with unique challenges for management and treatment. Although most foreign objects pass spontaneously, one should have a low threshold of intervention for multiple objects, especially those that are wide, sharp and at risk of perforation. Diagnosis is typically made when there is a history of ingestion coupled with corresponding radiographic verification. The symptoms tend to be non-specific although some patients are able to delineate where the discomfort level is, correlating with the site of impaction. Most foreign bodies pass spontaneously; however when multiple sharp objects are ingested, the gastroenterologist should perform endoscopic procedures to minimize the risks of bowel perforation. We describe here a successful case of multiple ingested foreign bodies retrieved across the C-loop of the duodenum and the pharynges-esophageal curve via endoscopy and review the literature of multiple foreign body ingestion.
Collapse
Affiliation(s)
- Sameer R Islam
- Sameer R Islam, Ebtesam A Islam, David Hodges, Kenneth Nugent, Sreerum Parupudi, Department of Internal Medicine and Gastroenterology, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, United States
| | | | | | | | | |
Collapse
|
8
|
Christie DB, Luke WD, Sedghi S. Ingested foreign-body retrieval: a novel new method. Gastrointest Endosc 2007; 65:169-71. [PMID: 17185101 DOI: 10.1016/j.gie.2006.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Accepted: 07/05/2006] [Indexed: 02/08/2023]
Affiliation(s)
- D Benjamin Christie
- Department of Surgery, Mercer University School of Medicine, Medical Center of Central Georgia, Macon, Georgia, USA
| | | | | |
Collapse
|
9
|
Eisen GM, Baron TH, Dominitz JA, Faigel DO, Goldstein JL, Johanson JF, Mallery JS, Raddawi HM, Vargo JJ, Waring JP, Fanelli RD, Wheeler-Harbough J. Guideline for the management of ingested foreign bodies. Gastrointest Endosc 2002; 55:802-6. [PMID: 12024131 DOI: 10.1016/s0016-5107(02)70407-0] [Citation(s) in RCA: 345] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
This is one of a series of statements discussing the utilization of gastrointestinal endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations.
Collapse
|
10
|
Abstract
This guideline is intended to aid the endoscopist in the management of adult patients with possible foreign object ingestion and/or food bolus impaction. A literature search was performed on the Medline using Medlars II, the National Library of Medicine's National Interactive Retrieval Service. This search generated 181 citations. References chosen for review were English-language citations from the gastroenterology, otolarygology, general surgical, and radiological literature. As little or no data exist from well-designed prospective trials, emphasis was given to results from large series, and reports from recognized experts. In preparing this guideline several drafts were distributed to the members of the ASGE Standards of Practice Committee, to the practice committees of the AGA, ACG, and SAGES, and to national experts on this subject for critical review. A final draft was then reviewed by the ASGE Governing Board. The final guideline reflects the input from this review process.
Collapse
|
11
|
Abstract
This review article is intended to aid the clinician in the evaluation and management of older children and adult patients with possible foreign object ingestion and/or food bolus impaction. A literature search was performed in June 1993 on the Medline using Medlars II, the National Library of Medicine's National Interactive Retrieval Service. This search generated 181 citations. References chosen for review were English-language citations from the gastroenterology, otolaryngology, general surgical, and radiological literature. As little or no data exist from well-designed prospective trials, emphasis was given to results from large series. In preparing this manuscript several drafts were distributed to the members of the American Society for Gastrointestinal Endoscopy, Standards of Practice Committee, and to national experts on the subject for critical review.
Collapse
Affiliation(s)
- G G Ginsberg
- Hospital of the University of Pennsylvania, Gastroenterology Division, Philadelphia 19104, USA
| |
Collapse
|
12
|
Haug RH, Kimberly D, Brandt CP. Management of an ingested iatrogenic foreign body: report of a case. J Oral Maxillofac Surg 1993; 51:593-6. [PMID: 8478770 DOI: 10.1016/s0278-2391(10)80522-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- R H Haug
- MetroHealth Medical Center, Cleveland, OH 44109
| | | | | |
Collapse
|