Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Evidence-Based Review Article

Magalhães-Costa, Pedro; Carvalho, Liliana; Rodrigues, José; Túlio, Maria Ana; Marques, Susana; Carmo, Joana; Bispo, Miguel; Chagas, Cristina

doi:10.1016/j.jpge.2015.09.002

Cited by 38 publications

(38 citation statements)

References 85 publications

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“…Various types of foreign body such as blunt or sharp objects are encountered in clinical practice in addition to food bolus (FB) impaction. The latter is more likely to occur in adults than in children and more commonly occurs in the elderly population and in those with underlying esophageal pathology [9]. Patients usually present with sore throat, dysphagia, odynophagia, and retrosternal pain or discomfort.…”

Section: Introductionmentioning

confidence: 99%

“…FB obstruction requires urgent endoscopic removal within 24 hours to avoid complications (e.g., perforation, retropharyngeal abscess, or fistula formation) and within 6 hours in patients with manifestations of complete esophageal obstruction (e.g., the inability to swallow liquids or hypersalivation) because these patients are at a high risk of aspiration and/or pressure necrosis [9].…”

Section: Introductionmentioning

confidence: 99%

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Cap-Assisted Technique versus Conventional Methods for Esophageal Food Bolus Extraction: A Comparative Study

et al. 2019

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Background/AimsFood bolus impaction is the most common form of esophageal foreign body impaction observed in adults. Clinical guidelines recommend using the push technique or retrieval methods in such cases. The push technique can cause injuries in certain clinical situations. Notably, conventional retrieval methods are time and effort consuming. Cap-assisted endoscopic extraction of an impacted food bolus is an easy and effective technique; however, more data are needed for its validation. This study compared the capassisted extraction technique with conventional methods. MethodsThis prospective observational multicenter study compared the success and en bloc removal rates, total procedure time, and adverse events in both techniques.. ResultsThe study included 303 patients who underwent food bolus extraction. The push technique was used in 87 patients (28.7%) and a retrieval procedure in 216 patients (71.3%). Cap-assisted extraction was performed in 106 patients and retrieval using conventional methods in 110 patients. The cap-assisted technique was associated with a higher rate of en bloc removal (80.2% vs. 15%, p<0.01), shorter procedure time (6.9±3.5 min vs. 15.7±4.1 min, p<0.001), and fewer adverse events (0/106 vs. 9/110, p<0.001). ConclusionsCap-assisted extraction showed no adverse events, higher efficacy, and a shorter procedure time compared with conventional retrieval procedures.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cap-Assisted Technique versus Conventional Methods for Esophageal Food Bolus Extraction: A Comparative Study

et al. 2019

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“…[1][2][3][4] Indeed, the need to perform radiological exams before endoscopy, the endoscopic methods used to retrieve the foreign body or FI and the postendoscopy attitude are generally decided on a case by case basis, based on the type, size, shape of the foreign body and also on physical examination and symptoms or signs of complications. [5][6][7][8][9][10] This contributes to significant heterogeneity in attitudes and also in their reporting, with some studies reporting FBI and FI therapeutics and outcomes together although they are different entities. [1][2][3] Endoscopy is the mainstay of diagnosis and treatment of FBI and FI, although some controversies exist concerning the indications and the best timing for its execution.…”

Section: Introductionmentioning

confidence: 99%

Foreign body ingestion and food impaction in adults: better to scope than to wait

et al. 2018

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Background and objective: To assess clinical outcomes after foreign body ingestion and food impaction; to identify predictors of foreign body presence at the time of endoscopy. Methods: A prospective study including consecutive adult patients with foreign body ingestion or suspected food impaction between May 2014 and August 2016. Results: In total, 521 patients were included, 320 with foreign body ingestion and 201 with suspected food impaction. Food impaction patients were significantly older and more frequently had a history of oesophageal disease. The foreign body was encountered in the upper digestive tract in 43% of the patients with foreign body ingestion, and food impaction was confirmed in 87%. Older age (odds ratio (OR) year 1.04, 95% confidence interval (CI) 1.02-1.06) and early presentation (OR first six hours 4.41, 95% CI 2.24-8.66) were independent predictors of foreign body presence, while a history of psychiatric disease was an independent predictor of food impaction (OR 6.69, 95% CI 1.66-26.9). Successful endoscopic treatment was achieved in more than 90% of the cases, with adverse events occurring in fewer than 5%. Foreign body forceps was the preferred device in foreign body ingestion, while retrieval basket and mobilisation were preferred in food impaction. The need to use more than one instrument was significantly higher in food impaction. Conclusion: Foreign bodies are encountered at endoscopy in almost half of the cases. Older age and earlier presentation are independent predictors of its presence. Given the high proportion of patients with foreign body at endoscopy and the low risk of complications, endoscopic evaluation is probably justified in the majority of cases.

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“…This is also consistent with study by Magalhães-Costa et al which states that foreign body impaction is more common in the extremes of ages. 12 So the age group of presentation is highly variable and both children and adults are at risks.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Management of Foreign Body Impaction in the Upper Gastrointestinal Tract in a Tertiary Care Centre of Nepal

Shrestha

Gurung

Sharma

et al. 2020

Kathmandu Univ. Med. J.

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Background Ingested foreign body impaction on upper gastrointestinal tract is common incidence among children, older age group, mentally challenged individuals, and people the influence of alcohol. In most cases, the foreign bodies pass spontaneously and uneventfully but when this does not occur; endoscopic management to ensure removal under direct visualization is required. Relief upon removal of foreign body and prevention of complications is essential. Objective To assess the endoscopic management and outcome of foreign body impacted in the upper gastrointestinal tract. Method This is a hospital based observational retrospective cross sectional study involving 165 patients at Endoscopy Department of Dhulikhel Hospital in Nepal between November 2015 and October 2019. The data regarding the demographic profile, clinical characteristics and endoscopic findings were retrieved and analyzed to determine endoscopic interventions performed, complications and outcomes. Result One hundred and sixty five patients presenting with history of ingestion of foreign body were included in the study. The mean age of the patients was 46.8 ± 19.1 years with male predominance (60%). The most common site of foreign body impaction was oesophagus (70%). The most common foreign body encountered was bone (62.2%) among which chicken bones (91.1%) were most frequent. For the retrieval of sharp-pointed foreign bodies, rat forceps and graspers (45.7%) were most commonly used. Total 14 cases required rigid oesophagoscopy as the foreign body could not be retrieved by flexible endoscopy. Conclusion Foreign body ingestion and its impaction in the upper gastrointestinal tract has been found to be common in endoscopic practise. Early detection and timely removal of foreign bodies is of utmost importance to avoid discomfort to the patient as well as to ensure successful removal without complications.

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Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: An Evidence-Based Review Article

Cited by 38 publications

References 85 publications

Cap-Assisted Technique versus Conventional Methods for Esophageal Food Bolus Extraction: A Comparative Study

Cap-Assisted Technique versus Conventional Methods for Esophageal Food Bolus Extraction: A Comparative Study

Foreign body ingestion and food impaction in adults: better to scope than to wait

Endoscopic Management of Foreign Body Impaction in the Upper Gastrointestinal Tract in a Tertiary Care Centre of Nepal

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