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Pham ST, Sakai O, Andreu-Arasa VC. Imaging approach to ingested foreign bodies in the neck. Neuroradiology 2024; 66:867-881. [PMID: 38619570 DOI: 10.1007/s00234-024-03348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
Foreign body ingestion is a common clinical occurrence worldwide, with high morbidity in the pediatric population and in adult patients with intentional attempts. Coins and button battery ingestions are more common among children. Bone impaction and swallowed dentures are usually seen in older adults. While most ingested foreign bodies pass through the gastrointestinal tract spontaneously with no complications, some require endoscopic and/or surgical intervention. Complications such as pharyngoesophageal ulceration, perforation, stricture, and deep neck infection can develop without timely diagnosis and management. The purpose of this article is to familiarize radiologists with the imaging approach to assess for characteristics and impacted locations of ingested foreign bodies in the neck.
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Affiliation(s)
- Serena T Pham
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Boston, MA, USA
| | - Osamu Sakai
- Division of Neuroradiology, Department of Radiology, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA
| | - V Carlota Andreu-Arasa
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Boston, MA, USA.
- Division of Neuroradiology, Department of Radiology, VA Boston Healthcare System, Boston, MA, USA.
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2
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Tai J, Gao K, Huang Z, Zhan B. Unusual Case of Esophageal Foreign Body: A Whole Mantis Shrimp. EAR, NOSE & THROAT JOURNAL 2024:1455613241249043. [PMID: 38642030 DOI: 10.1177/01455613241249043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024] Open
Abstract
Esophageal foreign bodies (FBs) are one of the common emergencies in otolaryngology, usually involving objects accidentally swallowed, and generally do not result in severe respiratory distress. This article presents an extremely rare case of an esophageal FB, where a 44-year-old man accidentally ingested an entire mantis shrimp while sucking its flavored tail, and was sent to the emergency department for severe throat pain and difficulty breathing. We immediately performed a laryngoscopy that revealed the FB that obstructs the entrance of the esophagus, obstructing the glottis due to the long shape of the shrimp. The mantis shrimp had barbs on its shell and trying to remove it intact would cause significant damage to the pharyngeal mucosa. Therefore, we extracted the mantis shrimp in segments under general anesthesia and applied electrocoagulation to stop bleeding from the damaged and bleeding posterior pharyngeal mucosa. As an esophagography was performed the following day, there were no signs of esophageal perforation. Through the detailed description and analysis of this case, our aim is to raise clinical awareness among physicians of such rare occurrences. Most important, appropriate examination and procedures of FBs should be performed based on the type, shape, and location of the FB.
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Affiliation(s)
- Junhu Tai
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
| | - Kai Gao
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
| | - Zhiwei Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
| | - Bin Zhan
- Department of Otorhinolaryngology-Head and Neck Surgery, Xiamen Medical College Affiliated Second Hospital, Xiamen, Fujian, China
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KC S, Gupta RK, Kumar A, Khanal B, Lamichhane S, Buhusal A, Sah VP, Bartaula S, Raki IH, Jindal R. Acute intestinal obstruction secondary to ingested foreign body in an adult with autism spectrum disorder: A rare case report and review of literature. Clin Case Rep 2024; 12:e8759. [PMID: 38617069 PMCID: PMC11009455 DOI: 10.1002/ccr3.8759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/11/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024] Open
Abstract
Key Clinical Message Foreign body ingestion is common in pediatric age group however can be found in any age group with intellectual disability and neurodevelopmental delay. There is usually a delay in presentation and interventions following foreign body ingestion in patients with neurodevelopmental delay, leading to increased morbidity, mortality, and complications owing to inability of such patients giving relevant history. Most ingested foreign bodies naturally pass through the digestive tract without untoward effects. Only a few patients may require surgical interventions. Principle of management should be to reduce anxiety among patients and their visitors. Speedy recovery is enhanced so that they can return to their familiar environment soon. Abstract Foreign body ingestion is common in pediatric populations and may be found in any age group with intellectual disability and neurodevelopmental delay. As the patient cannot give a clear and relevant history, there is usually a delay in presentation and interventions following foreign body ingestion in patients with neurodevelopmental delay, leading to increased morbidity, mortality, and complications. Most foreign bodies pass through the digestive system without any complications, and very few require surgical intervention. The goal should be to reduce anxiety among patients and their visitors and to enhance speedy recovery so that they can return to their familiar environment soon. Here we report a case of Acute intestinal obstruction secondary to ingestion of the head portion of a doll which was managed with emergency laparotomy with enterotomy and removal of foreign body in a 16 years female with Autism Spectrum Disorder.
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Affiliation(s)
- Suraj KC
- Department of General SurgeryBPKIHSDharanNepal
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Low Kapalu CM, Uraizee O, Lerner DG, Thomson M, Attard T. Endoscopist experience with pediatric recurrent and intentional foreign body ingestion (RIFBI): Management considerations and future directions. J Pediatr Gastroenterol Nutr 2024; 78:711-719. [PMID: 38284750 DOI: 10.1002/jpn3.12114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVES AND STUDY Accidental foreign body ingestion (FBI) is a common pediatric referral concern. In contrast, recurrent and intentional FBI (RIFBI) is infrequent and associated with greater endoscopic and surgical intervention in adults. Although pediatric guidelines exist for FBI, the risk and therapeutic implications of RIFBI are not addressed. An anonymous international survey on pediatric gastroenterologist experience with RIFBI was distributed. METHODS A 33-item REDCap© survey was distributed via email to pediatric gastroenterologists identified through mailing and email lists obtained from pediatric gastroenterology professional organizations. RESULTS During 9-12/2021 we accrued 202 completed surveys. Respondents were from 27 countries and across the career span. Eighty percent reported experience with RIFBI; 74% reported seeing ≤ 3 patients with RIFBI within the past 24 months and 4% reported seeing ≥ 6. Of those who treated RIFBI, 38% reported an average number of annual ingestions per patient was ≥5. Frequent morbidity but not mortality was reported. Half reported adherence to FBI guidelines. Later-career endoscopists treated RIFBI more aggressively than accidental ingestion. Ninety-six percent noted that patients with RIFBI had psychiatric comorbidities. Providers at academic medical centers reported referring to behavioral health more than those in other settings. CONCLUSION Most gastroenterologists surveyed reported encountering RFBI several times a year and in patients with psychiatric comorbidities. Greater likelihood of adverse outcomes associated with endoscopy was reported. Most reported referral to behavioral health and few had RIFBI management protocols. A broader spectrum of psychologic comorbidities in the pediatric population with RIFBI, notably depression and autism spectrum disorder, were reported.
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Affiliation(s)
- Christina M Low Kapalu
- Pediatric Psychology and Gastroenterology, Oregon Health & Science University, Portland, Oregon, USA
- Gastroenterology, Hepatology and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, USA
- Department of Pediatrics, University of Missouri Kansas City, Kansas City, Missouri, USA
| | - Omar Uraizee
- College of Osteopathic Medicine, Kansas City University, Kansas City, Missouri, USA
| | - Diana G Lerner
- Section of Gastroenterology, Hepatology, and Nutrition, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mike Thomson
- Sheffield Children's Hospital NHS Foundation Trust, Sheffield, UK
| | - Thomas Attard
- Gastroenterology, Hepatology and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, USA
- Department of Pediatrics, University of Missouri Kansas City, Kansas City, Missouri, USA
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Zhang M, Wan J, Zhou Q. Time trends and endoscopic management of foreign body ingestion in the upper GI tract: a retrospective analysis of 1,152 cases in China. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2023; 115:488-495. [PMID: 36896925 DOI: 10.17235/reed.2023.9426/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
OBJECTIVES foreign body ingestions are encountered in the clinical practice and sometimes require endoscopic management. However, time trends and epidemiology of these cases have not been fully clarified. Whether seasons and festivals have an effect on the occurrence has been poorly described. METHOD from 2009 to 2020, 1,152 consecutive foreign body ingestion cases were enrolled in our endoscopic center. Case records were reviewed for demographic data, foreign body type and location, outpatient or hospitalization, adverse events and dates. Annual time trends and seasonal variation were analyzed as well as the influence of Chinese legal festivals on the incidence. The impact of SARS-CoV-2 pandemic on the potential delay for clinical consultation of these cases was preliminarily explored. Clinical features of these cases were demonstrated. RESULTS the overall success rate was 99.7 % and the adverse events rate was 2.4 %. There was an uptrend in the annual frequency of food foreign body ingestion endoscopic extraction from 0.65 in 2009 to 8.86 in 2020 per 1,000 esophagogastroduodenoscopy patients (r = 0.902, p < 0.001). Furthermore, the frequency of endoscopic extraction significantly increased in winter (p < 0.001) and during Chinese New Year celebratory season (p = 0.003). The duration of hospitalization may be longer in the pandemic period (p = 0.0049). CONCLUSION considering the uptrend of the annual frequency of food related foreign body endoscopic extraction, the publicity about the danger of foreign body ingestion should be enhanced. Arrangement of endoscopic physicians and assistants during the high-incidence season should be emphasized.
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Affiliation(s)
- Miaoxin Zhang
- Gastroenterology, Tongji Hospital. Tongji Medical College, Huazhong University of Science and Technology, China
| | - Junchen Wan
- Gastroenterology, Tongji Hospital. Tongji Medical College, Huazhong University of Science and Technology, China
| | - Qi Zhou
- Gastroenterology, Tongji Hospital. Tongji Medical College, Huazhong University of Science and Technology, China
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Calini G, Ortolan N, Battistella C, Marino M, Bresadola V, Terrosu G. Endoscopic failure for foreign body ingestion and food bolus impaction in the upper gastrointestinal tract: an updated analysis in a European tertiary care hospital. Eur J Gastroenterol Hepatol 2023; 35:962-967. [PMID: 37395211 DOI: 10.1097/meg.0000000000002602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE Harmfulness of foreign body ingestion and food bolus impaction (FBIs) varies according to geographical area, population, habits, and diet. Therefore, studies may not draw generalizable conclusions. Furthermore, data regarding FBIs management in Europe are limited and outdated. This study aimed to analyze the endoscopic management and outcomes of FBIs in an Italian tertiary care hospital to identify risk factors for endoscopic failure. METHODS We retrospectively reviewed patients who underwent upper gastrointestinal endoscopy for FBIs between 2007 and 2017. Baseline, clinical, FBIs, and endoscopic characteristics and outcomes were collected and reported using descriptive statistics and logistic regression analyses. RESULTS Of the 381 endoscopies for FBIs, 288 (75.5%) were emergent endoscopy and 135 (35,4%) included underlying upper gastrointestinal conditions. The study population included 44 pediatric patients (11.5%), 54 prisoners (15.8%), and 283 adults (74.2%). The most common type and location of FBIs were food boluses (52.9%) and upper esophagus (36.5%), respectively. While eight patients (2.1%) developed major adverse events requiring hospital admission, the remainder (97.9%) were discharged after observation. No mortality occurred. Endoscopic success was achieved in 263 of 286 (91.9%) verified FBIs endoscopies. Endoscopic failure (8.04%) was associated with age, bone, disk battery, intentional ingestion, razor blade, prisoners, and stomach in the univariate analysis. Multivariate logistic regression revealed that intentional ingestion was associated with endoscopic failure (odds ratio: 7.31; 95% confidence interval = 2.06-25.99; P = 0.002). CONCLUSION Endoscopy for FBIs is safe and successful, with low hospital admission rate in children, prisoners, and adults. Intentional ingestion is a risk factor of endoscopic failure.
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Affiliation(s)
- Giacomo Calini
- Department of Surgery, University Hospital 'Santa Maria della Misericordia', University of Udine
| | | | - Claudio Battistella
- Department of Medical and Biological Sciences, Section of Statistics, University of Udine
| | - Marco Marino
- Gastroenterology and GI Endoscopy Unit, University Hospital of Udine, Udine, Italy
| | - Vittorio Bresadola
- Department of Surgery, University Hospital 'Santa Maria della Misericordia', University of Udine
| | - Giovanni Terrosu
- Department of Surgery, University Hospital 'Santa Maria della Misericordia', University of Udine
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Stojkovic S, Bjelakovic M, Stojkovic Lalosevic M, Stulic M, Pejic N, Radivojevic N, Stojkovic N, Martinov Nestorov J, Culafic D. Accidental Sewing Pin Ingestion by a Tailor: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1566. [PMID: 37763686 PMCID: PMC10534428 DOI: 10.3390/medicina59091566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/17/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023]
Abstract
Foreign body ingestion is a frequently encountered emergency in healthcare institutions. It mostly affects pediatric populations, although it can also affect adults with developmental delays, those with psychiatric diseases, drug abusers, and prisoners. Endoscopy is a diagnostic and treatment method for suspected foreign body ingestion. In this article, we discuss a 45-year-old tailor who swallowed a sewing pin while at work. The abdominal X-ray showed a needle-shaped metal shadow in the stomach region. During an upper endoscopy, it was discovered that a sewing pin with a sharp edge was stuck in the pylorus. The sewing pin was extracted endoscopically, and the patient was discharged the same day in good condition. Since the estimated risk of complications of foreign body ingestion in the adult population is about 35%, and the most common complications include impaction, laceration, bleeding, or perforation of the gastrointestinal wall, endoscopic or surgical removal is necessary. This also emphasizes the importance of a careful endoscopic evaluation of some at-risk occupations for foreign body ingestion with or without gastrointestinal complaints.
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Affiliation(s)
- Stefan Stojkovic
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Milica Bjelakovic
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Nis, 18000 Nis, Serbia
| | - Milica Stojkovic Lalosevic
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milos Stulic
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nina Pejic
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Nemanja Radivojevic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Nemanja Stojkovic
- Department of Cardiology, University Clinical Hospital Center “Dr. Dragisa Misovic-Dedinje”, 11000 Belgrade, Serbia
| | - Jelena Martinov Nestorov
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Djordje Culafic
- Clinic for Gastroenterology and Hepatology, University Clinical Center of Serbia, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Ngu NLY, Karp J, Taylor K. Patient characteristics, outcomes and hospital-level healthcare costs of foreign body ingestion from an Australian, non-prison referral centre. BMJ Open Gastroenterol 2023; 10:bmjgast-2022-001087. [PMID: 36796876 PMCID: PMC9936287 DOI: 10.1136/bmjgast-2022-001087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/19/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Foreign body ingestion (FBI) occurs infrequently but can be associated with rare risks including perforation. There is limited understanding of the impact of adult FBI in Australia. We aim to evaluate patient characteristics, outcomes and hospital costs of FBI. DESIGN A retrospective cohort study of patients with FBI was performed at a non-prison referral centre in Melbourne, Australia. International Classification of Disease-10 coding identified patients with gastrointestinal FBI over financial years 2018-2021. Exclusion criteria were food bolus, medication foreign body, object in anus or rectum, or non-ingestion. Criteria for 'emergent' classification were oesophagus, size >6 cm, disc batteries, airway compromise, peritonitis, sepsis and/or suspected viscus perforation. RESULTS Thirty-two admissions attributed to 26 patients were included. The median age was 36 years (IQR: 27-56), 58% were male and 35% had a prior psychiatric or autism spectrum disorder. There were no deaths, perforations or surgery. Gastroscopy was performed in 16 admissions and 1 was scheduled following discharge. Rat-tooth forceps were used in 31% and an overtube was used in 3 cases. The median time from presentation to gastroscopy was 673 minutes (IQR: 380-1013). Management was adherent to European Society of Gastrointestinal Endoscopy guidelines in 81%. After excluding admissions with FBI as a secondary diagnosis, median admission cost was $A1989 (IQR: $A643-$A4976) and total admission costs over the 3 years was $A84 448. CONCLUSION FBI in an Australian, non-prison referral centre is infrequent, can often be safely managed expectantly, and has limited impact on healthcare utilisation. Early, outpatient endoscopy could be considered for non-urgent cases, which may reduce costs while maintaining safety.
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Affiliation(s)
- Natalie Lee Yee Ngu
- Department of Gastroenterology and Hepatology, Alfred Health, Melbourne, Victoria, Australia .,Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Jadon Karp
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Kirstin Taylor
- Department of Gastroenterology and Hepatology, Alfred Health, Melbourne, Victoria, Australia
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Chauhan A, Bodh V, Sharma R, Sharma B. Intentional Ingestion of a Foreign Body - Why We Need Psychiatrists. Middle East J Dig Dis 2023; 15:57-59. [PMID: 37547154 PMCID: PMC10404070 DOI: 10.34172/mejdd.2023.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 10/11/2022] [Indexed: 08/08/2023] Open
Abstract
Foreign body ingestions are common medical emergencies. In adults, foreign body ingestions occur in patients with psychiatric disorders and prison inmates. A majority (80-90%) of foreign bodies pass spontaneously. Endoscopic and surgical interventions are required in only 10-20% and 1%, respectively. A plain radiograph may be the only diagnostic test required. A computed tomography scan may be needed when a perforation is suspected. Food boluses are the most commonly ingested foreign bodies. Snare and rat tooth forceps are frequently used accessories for the retrieval of foreign bodies. The focus of the emergency team is on the management of an acute case of foreign body ingestion, and the psychiatric aspect of the disease gets often ignored.
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Affiliation(s)
- Ashish Chauhan
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, India
| | - Vishal Bodh
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, India
| | - Rajesh Sharma
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, India
| | - Brij Sharma
- Department of Gastroenterology, Indira Gandhi Medical College, Shimla, India
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Xu D, Qian H, Lian L, Xie M, Zhang H. Management strategy of a carotid-esophageal fistula with a right common carotid artery pseudoaneurysm due to chicken bone ingestion: A case report and literature review. Front Surg 2023; 10:1129488. [PMID: 37114155 PMCID: PMC10126472 DOI: 10.3389/fsurg.2023.1129488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Common carotid artery (CCA) pseudoaneurysm is a rare clinical disorder. CCA pseudoaneurysm that occurs with a carotid-esophageal fistula and causes massive upper gastrointestinal bleeding is especially uncommon but can be life-threatening. Accurate diagnosis and prompt managements are essential to save lives. Here, we report a case of a 58-year-old female who presented with dysphagia and throat pain after accidental ingestion of a chicken bone. The patient presented with active upper gastrointestinal bleeding which quickly developed into hemorrhage shock. Imaging studies confirmed a diagnosis of right CCA pseudoaneurysm and carotid-esophageal fistula. The patient had a satisfactory recovery after a right CCA balloon occlusion, right CCA pseudoaneurysm excision, and right CCA and esophageal repairs. We present and discuss this case here to remind physicians to rule out rare causes of upper gastrointestinal bleeding. A multidisciplinary approach is commonly required to achieve satisfactory outcomes in these cases.
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Affiliation(s)
- Dongming Xu
- Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Haichao Qian
- General Administration of Customs (Beijing) InternationalTravel Health Care Center, Beijing, China
| | - Lishan Lian
- Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Miaorong Xie
- Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hanyu Zhang
- Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China
- Correspondence: Hanyu Zhang
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Boumarah DN, Binkhamis LS, AlDuhileb M. Foreign body ingestion: Is intervention always a necessity? Ann Med Surg (Lond) 2022; 84:104944. [PMID: 36582912 PMCID: PMC9793207 DOI: 10.1016/j.amsu.2022.104944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/31/2022] [Accepted: 11/13/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Intentional and accidental foreign body ingestion are commonly encountered in clinical practice. In adults, intentional foreign body ingestion is frequently observed among individuals with psychiatric disorders and prisoners. Controversies exist regarding the management of sharp or pointed objects. We contribute to this existing controversy by presenting a case of a 43-year-old male who accidently ingested a metallic screw and was managed successfully through endoscopic retrieval. Case presentation We discuss a case of a 43-year-old male presented to our emergency department after accidently swallowing a metallic screw, 1 h and a half prior to his presentation. He was initially asymptomatic then started to complain of vague abdominal symptoms. X-rays of the chest and abdomen demonstrated the presence of a metallic screw at the mid-abdomen. Computed tomography scan of the abdomen then confirmed its presence within the gastric lumen, with no evidence of gastric or bowel perforation. The patient was managed via esophagogastroduodenoscopy in which the ingested screw was extracted. He was discharged after 24 hours in a good condition. Clinical discussion A limited number of epidemiological studies have shed light on the prevalence and incidence of foreign body ingestion among adult individuals. Probability of spontaneous passage depends on several factors including the size, shape and composition of the impacted item, as well as the age of patient and duration of ingestion prior to presentation. Conclusion Considering the variation of ingested objects and the availability of several therapeutic approaches, a patient-tailored management plan should always be established.
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Affiliation(s)
- Dhuha N. Boumarah
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia,Corresponding author.
| | - Lujain S. Binkhamis
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia
| | - Mohammed AlDuhileb
- Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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12
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Kaplan TT, Çakır RC, Çöpelci Y, Öner OZ, Koşar MN. Non-Accidental Foreign Body Ingestion Among Prisoners in Turkey. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03605-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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13
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Tagliaferri AR, Melki G, Feghali C, Cavanagh Y. Accidental ingestion of an endodontic file: A case report and literary review. Radiol Case Rep 2022; 17:4928-4931. [PMID: 36304075 PMCID: PMC9593291 DOI: 10.1016/j.radcr.2022.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022] Open
Abstract
Ingestion and aspiration can be accidental or intentional events in both adults and children. Approximately 1500 people in the United States die from ingestion of foreign bodies annually. Patients with cognitive disabilities, neurological disorders, elderly age or incarcerated patients carry the highest risk of intentional and/or accidental ingestion of foreign objects. Although uncommon, ingestion of foreign objects during dental procedures can be potentially life-threatening and increased awareness is important. Sharp objects ingested from dental procedures can cause impaction, obstruction, hemorrhage, or perforation and may need endoscopic or surgical intervention. Herein we report a case of a 22-year-old male, who underwent routine dental cleaning and accidentally ingested an endodontic file, retrieved from the ascending colon endoscopically without complications.
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bozorgmehr R, Bahadorinia M, Pouyanfar S, ahmadinejad M, bahri MH, Bagherpour JZ. A rare case of abdominal foreign bodies; laparoscopic removal of a sewing needle. Ann Med Surg (Lond) 2022; 82:104747. [PMID: 36268315 PMCID: PMC9577834 DOI: 10.1016/j.amsu.2022.104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/17/2022] [Accepted: 09/18/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ramin bozorgmehr
- Department of Surgery Shahid Madani Hospital, Alborz University of Medical Sciences Alborz, Iran
| | - Mahsa Bahadorinia
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Shiva Pouyanfar
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Mojtaba ahmadinejad
- Department of Surgery Shahid Madani Hospital, Alborz University of Medical Sciences Alborz, Iran
| | - Mohammad hadi bahri
- Department of Surgery Shahid Madani Hospital, Alborz University of Medical Sciences Alborz, Iran
| | - Javad Zebarjadi Bagherpour
- Department of Surgery Shahid Madani Hospital, Alborz University of Medical Sciences Alborz, Iran
- Corresponding author. Department of Surgery, Alborz University of Medical Sciences, Tehran, Iran.
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Negrete JR, Carrillo MD, Molina GA, Ayala O AV, Flores D, Castillo D. Do not open wide; accidentally swallowed dental mold causing bowel obstruction. A case report. J Surg Case Rep 2022; 2022:rjac384. [PMID: 36118991 PMCID: PMC9473515 DOI: 10.1093/jscr/rjac384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
Foreign body ingestion is a common condition in daily practice; fortunately, most cases do not require endoscopic or surgical treatment, as most foreign bodies pass through the intestine without injuring it. Although mainly seen in children, adults can also be affected, especially in accidental situations and suicide attempts. Therefore, the clinical history and the environment in which the event occurred are essential for a rapid diagnosis. This can be even more challenging as most adult patients are rarely aware of ingestion. Therefore, a high index of suspicion is necessary. Therapy will depend on the foreign body’s size, shape and material; treatment should not be delayed if complications are detected. We present a case of a 34-year-old man who accidentally swallowed the mold of his teeth while undergoing a dental procedure. Subsequently, he presented with an intestinal obstruction that required surgery. Fortunately, he made a full recovery.
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Affiliation(s)
- Jose R Negrete
- Department of General Surgery Hospital Vozandes , AXXIS Hospital & UIDE, Quito , Ecuador
| | | | - Gabriel A Molina
- Department of General Surgery Hospital Metropolitano & Universidad San Francisco de Quito (USFQ) , Quito , Ecuador
| | - Andres V Ayala O
- Department of General Surgery AXXIS Hospital & UIDE , Quito , Ecuador
| | | | - Daniel Castillo
- Department of Internal Medicine AXXIS Hospital , Quito , Ecuador
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16
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Zanchetta M, Monti E, Latham L, Costa J, Marzorati A, Odeh M, Colombo EM, Ietto G, Inversini D, Iovino D, Maffioli MP, Festi LF, Carcano G. Dental Prosthesis in Esophagus: A Right Cervicotomic Approach. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081170. [PMID: 36013349 PMCID: PMC9409762 DOI: 10.3390/life12081170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
Foreign body ingestion in the upper digestive tract is a relatively common emergency. Less than 1% have to be treated surgically. We report the case of a 68-year-old man who ingested a dental prosthesis, probably during a seizure, and thus unknowingly, and presented two days later to the emergency department complaining of a mild dysphagia. A chest radiograph showed the presence of a removable dental prosthesis in the upper esophageal tract. The patient was brought to the operating room where a multidisciplinary equipe was assembled. Two attempts of retrieval with a flexible and a rigid endoscope failed because the removable dental prosthesis was stuck in the right pyriform sinus. Therefore, the surgeon performed an uncommon right cervicotomy and retrieved the foreign body through a right-side esophagotomy. The surgical approach depends on the nature and location of the foreign body. Urgent treatment is required whenever the patient develops dyspnea or dysphagia because of the high risk of inhalation and asphyxia. Removal of any esophageal foreign body has to be performed within 12-24 h. Repeated attempts to retrieve large dental prosthesis using an endoscope may result in esophageal perforation therefore when such risk of complication is too high, a surgical approach becomes inevitable. In our opinion, surgery remains the extrema ratio after a failed endoscopic retrieval attempt but can be lifesaving despite high risk of complications.
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Affiliation(s)
- Matteo Zanchetta
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, 21100 Varese, Italy; (E.M.); (J.C.); (G.I.); (D.I.); (M.P.M.); (G.C.)
- Correspondence:
| | - Elisa Monti
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, 21100 Varese, Italy; (E.M.); (J.C.); (G.I.); (D.I.); (M.P.M.); (G.C.)
| | - Lorenzo Latham
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Jessica Costa
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, 21100 Varese, Italy; (E.M.); (J.C.); (G.I.); (D.I.); (M.P.M.); (G.C.)
| | - Alessandro Marzorati
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Murad Odeh
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Elisabetta Marta Colombo
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Giuseppe Ietto
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, 21100 Varese, Italy; (E.M.); (J.C.); (G.I.); (D.I.); (M.P.M.); (G.C.)
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Davide Inversini
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, 21100 Varese, Italy; (E.M.); (J.C.); (G.I.); (D.I.); (M.P.M.); (G.C.)
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Domenico Iovino
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Marco Paolo Maffioli
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, 21100 Varese, Italy; (E.M.); (J.C.); (G.I.); (D.I.); (M.P.M.); (G.C.)
- Otorinolaringoiatria, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy
| | - Luigi Fiorenzo Festi
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
| | - Giulio Carcano
- Dipartimento di Medicina e Chirurgia, Università degli Studi dell’Insubria, 21100 Varese, Italy; (E.M.); (J.C.); (G.I.); (D.I.); (M.P.M.); (G.C.)
- Chirurgia Generale d’Urgenza e Trapianti, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy; (L.L.); (A.M.); (M.O.); (E.M.C.); (D.I.); (L.F.F.)
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17
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Accidental or intentional ingestion of toothbrushes: experience with 8 adult patients. Emerg Radiol 2022; 29:377-382. [PMID: 35022861 DOI: 10.1007/s10140-021-02009-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Ingestion of a toothbrush is an unusual event but may occur either accident or by intent. Radiological examinations play a crucial role in determining the exact location of the object within the gastrointestinal tract and in planning for its removal by endoscopic or surgical intervention. METHODS Medical and radiological records of 8 patients who had swallowed the broken heads or entire toothbrush were retrospectively reviewed. This series included 4 men and 4 women, ranging in age from 21 to 57 years (mean: 34 years). RESULTS Radiographs and computed tomography of the abdomen demonstrated the ingested toothbrushes within the stomach in 3, lodged in the duodenum in 1, and entrapped in various parts of the colon in 4 patients. They were removed by laparotomy in 3, laparoscopy in 2, colonoscopy in 2, and upper gastrointestinal endoscopy in 1 patient. There were no perforations or associated complications, and all patients had uneventful recoveries. CONCLUSIONS Ingested toothbrushes can be easily identified on radiological studies because of the radiopaque wires holding the nylon bristles. The plastic parts of it, however, are only visible on computed tomography. All cases would require endoscopic or surgical removal of the retained toothbrushes because spontaneous passage per rectum does not occur.
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Foreign Body Ingestion in Neurologically Impaired Children: A Challenging Diagnosis and Management in Pediatric Surgery. CHILDREN 2021; 8:children8110956. [PMID: 34828669 PMCID: PMC8624601 DOI: 10.3390/children8110956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 11/26/2022]
Abstract
Children with intellectual disability/neurodevelopmental delay (ID-ND) commonly ingest foreign bodies (FB) and often present complications due to peculiar aspects of their condition. The aim of this paper is to report the experience of two centers in the management of ID-ND patients after FB ingestion and to discuss a possible algorithm for clinical practice. We retrospectively evaluated data of patients managed for FB ingestion (period: 2017–2021), focusing on those with ID-ND, specifically demographics and baseline diagnosis, elements related to the event, symptoms, time to endoscopy, FB location, endoscopic details, and follow-up. A total of 457 patients were managed in the study period and 19 had ID-ND (mean age 9.8 ± 3.5 years, 15 males). A total of 16/19 (84.2%) were symptomatic and required an operative approach. Recurrent ingestions and multiple FB were found in 2 and 11 patients, respectively. Endoscopy (mean time 65.6 ± 41 min) was effective in 14 cases (73.6%) and 6 patients (31.6%) developed a complication. FB ingestion in ID-ND patients represents a challenging condition for the clinician and a potentially dangerous situation. It should be addressed specifically by a multidisciplinary team considering a tailored diagnostic and management protocol.
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Pantazopoulos I, Mavrovounis G, Mermiri M, Adamou A, Gourgoulianis K. Intentional ingestion of batteries and razor blades by a prisoner: a true emergency? Int J Prison Health 2021; 18:316-322. [PMID: 34549561 DOI: 10.1108/ijph-06-2021-0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE Few case studies in the literature report on adult patients with intentional foreign body ingestion. Prisoners deliberately ingest foreign bodies, such as cylindrical alkaline batteries and razor blades, to achieve hospitalization or commit suicide. The purpose of this paper is to present a case of deliberate ingestion of batteries and razor blades by an inmate. DESIGN/METHODOLOGY/APPROACH The authors present a case of an incarcerated man in Greece, who intentionally ingested three cylindrical alkaline batteries and three razor blades wrapped in aluminum foil. FINDINGS The patient was treated conservatively with serial radiographs and was subsequently discharged without complication. This paper discusses the complications and examine the current guidelines available. ORIGINALITY/VALUE To best of authors' knowledge, this is the first report of a simultaneous ingestion of batteries and razor blades.
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Affiliation(s)
| | | | - Maria Mermiri
- Department of Emergency Medicine, University of Thessaly Volos Greece
| | - Antonis Adamou
- Department of Radiology, University of Thessaly Volos Greece
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20
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Wang X, Zhao J, Jiao Y, Wang X, Jiang D. Upper gastrointestinal foreign bodies in adults: A systematic review. Am J Emerg Med 2021; 50:136-141. [PMID: 34365062 DOI: 10.1016/j.ajem.2021.07.048] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/04/2021] [Accepted: 07/24/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Foreign body(FB) ingestion in the upper digestive tract is a common emergency that lacks sufficient attention in adult population. Improper management may bring additional injuries and financial burdens to patients. This review was performed to determine the clinical characteristics of upper gastrointestinal FBs, including the demographic of adult patients, the type and location of FBs, underlying diseases of patients and other risk factors, and outcomes. METHODS We searched PubMed, MEDLINE, EMBASE and Cochrane databases with the terms "foreign body AND upper gastrointestinal NOT child". Finally, we got 7 articles between 2001 and 2020 and extracted the information. RESULTS A total of 1391 patients were included. 736 (52.9%) patients were males and 655 (47.1%) were females. Fish bone was the most common type of FBs. Esophagus accounts for the most location in the upper digestive tract. 18.2% (235/1291) patients had the underlying diseases, and 11.7% (58/494) had other risk factors. The overall complication rate was 4.5% (63/1391).
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Affiliation(s)
- Xinyue Wang
- Department of Burns and Plastic Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, PR China
| | - Jie Zhao
- Department of Emergency Medical Center, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, PR China
| | - Ya Jiao
- Department of Emergency Medical Center, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, PR China
| | - Xinglei Wang
- Department of Emergency Medical Center, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, PR China
| | - Duyin Jiang
- Department of Emergency Medical Center, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, PR China; Department of Burns and Plastic Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, PR China.
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21
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Tavallaei M, Bahadorinia M, Haj Mohamad Ebrahim Ketabforoush A. Intentional Ingestion of a Metallic Wire Causing Perforation and Retroperitoneal Abscess: A Case Report. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2021; 14:11795476211025919. [PMID: 34262387 PMCID: PMC8252360 DOI: 10.1177/11795476211025919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/30/2021] [Indexed: 12/11/2022]
Abstract
Foreign body ingestion is a frequent condition, with the majority of foreign bodies (FBs) tending to spontaneously proceed along the gastrointestinal tract without any major complications. A wide range of procedures are available to remove FBs; however, a real challenge exists in managing sharp, rigid, and long foreign objects, which are related to higher rates of complications. A 34-year-old man who intentionally swallowed a metallic wire of 20 cm length, presented to our ED with abdominal pain 2 weeks after the ingestion. The FB had migrated to the stomach and duodenum. Complications included perforation of the duodenum and ascending colon and a retroperitoneal abscess. FB removal was done via laparotomy, followed by the repair of perforations and damaged tissues. This case highlights the complications of a FB presence in the gastrointestinal tract for 14 days and emphasizes the importance of urgent and appropriate management of such conditions.
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Affiliation(s)
- Mehdi Tavallaei
- Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahsa Bahadorinia
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
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Yadollahi S, Buchannan R, Tehami N, Stacey B, Rahman I, Boger P, Wright M. Endoscopic management of intentional foreign body ingestion: experience from a UK centre. Frontline Gastroenterol 2021; 13:98-103. [PMID: 35300468 PMCID: PMC8862457 DOI: 10.1136/flgastro-2021-101776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE We report on the increasing incidence and outcomes from intentional foreign body ingestion (iFoBI) presenting to our hospital over a 5-year period. The aim was to assess the impact on services and to identify ways to safely mitigate against this clinical challenge. DESIGN/METHOD We performed a retrospective observational study of all patients presenting to a university hospital between January 2015 and April 2020 with iFoBI with a focus on objects swallowed, timing of endoscopy and clinical outcomes. RESULTS 239 episodes of iFoBI in 51 individuals were recorded with a significant increase in incidence throughout the study period (Welch (5, 17.3)=15.1, p<0.001), imposing a high burden on staff and resources. Items lodged in the oesophagus were more likely to lead to mucosal injury (p=0.009) compared with elsewhere. Ingested item type and timing of endoscopy were not related to complications (p=0.78) or length of stay (p=0.8). In 12% of cases, no objects were seen at endoscopy. CONCLUSION In all except those patients with oesophageal impaction of the object on radiograph, there is no need to perform endoscopic extraction out of hours. A subset of cases can avoid endoscopy with an X-ray immediately prior to the procedure as a significant proportion have passed already. We discuss more holistic approaches to deal with recurrent attendances.
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Affiliation(s)
- Sina Yadollahi
- Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ryan Buchannan
- Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK,Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nadeem Tehami
- Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Bernard Stacey
- Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Imbadhur Rahman
- Gastroenterology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Philip Boger
- Gastroenterology, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark Wright
- Hepatology, University Hospital Southampton, Southampton, Hampshire, UK
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