Endoscopic management of foreign bodies in the upper gastrointestinal tract: a retrospective study of 1294 cases

Geng, Chong; Li, Xiao; Luo, Rong; Cai, Lin; Lei, Xuelian; Wang, Chunhui

doi:10.1080/00365521.2017.1350284

Cited by 67 publications

(79 citation statements)

References 21 publications

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“…13 That study included minor haematomas and ulcerations as complications, which justify the higher complication rate. However, we consider that minor endoscopic findings should not be reported as complications because they will not alter management in the majority of cases, as also suggested by the American Society of Gastrointestinal Endoscopy (ASGE).…”

Section: Discussionmentioning

confidence: 99%

“…This estimate of 80% is based on old studies performed before the era of flexible endoscopy and when conservative treatment was the preferred management. 11,12 In addition, most of the recent studies on this topic include only patients with confirmed foreign body presence at endoscopy, 13 and so the proportion of patients with FBI in whom the foreign body will be encountered at endoscopy is not precisely known. Thus it is important to assess the proportion of patients with FBI in which the foreign body is encountered at endoscopy and also to identify predictors for its presence, because it can identify patients with a higher probability of actually having a foreign body in the upper digestive tract, and it can modify the threshold to perform endoscopy.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

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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“…Most studies in Asia and coastal countries reported that bone fragments, especially fish bones, are most commonly encountered. 3,12,13,16,18,24 While studies in the United States showed that meat comprised the majority type. 13,25 A systematic review including 13 092 patients all over the world revealed sharp-pointed FB (38.1%) as the most common FB.…”

Section: Discussionmentioning

confidence: 99%

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

et al. 2020

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Objectives: To propose a management algorithm for adult patients with sharp-pointed esophageal foreign-body impaction (EFBI) who have rigid endoscopy (RE) indications and to conduct a retrospective analysis of their data. Methods: All adult patients who received RE at the Department of Otorhinolaryngology in Beijing Shijitan Hospital between January 2017 and May 2019 were enrolled. The demographics, clinical characteristics, and management data were collected and analyzed. Results: A total of 130 patients were identified, 56.9% were female with median age 60 years. More than half (56.9%) of patients had foreignbody (FB) ingestion on holidays. The most frequent FBs were jujube pits (66.9%) and bones (23.8%). There is a significant female predominance in ingestion of jujube pits (65.5%, P ¼ .005). The most common symptoms were odynophagia (49.2%) and sore throat (47.7%). The majority (96.8%) of FB founded were lodged at upper esophagus. In all, 74 patients were categorized as having mild complications and 54 having significant complications. Time interval from ingestion to presentation longer than 15 hours was an independent risk factor for significant complications, while esophagogram with barium as a protective factor. Conclusions: Long-time interval from ingestion to presentation will lead to high risk of significant complications. Computed tomography should be a prioritized imaging method for all patients suspected with EFBI, and multidisciplinary collaboration is recommended. Besides, mass education on eating habits is necessary.

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“…Third, the inappropriate interventions by patients may worsen the condition. For example, trying to remove a foreign object by bolus ingestion of food may worsen the gastrointestinal trauma [8]. Therefore it should be recognized that pointed objects, long foreign bodies, and the presence of complications are important risk factors for further complications [7].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic extirpation of a fork after three days; Case report and review of the literature

Cengız¹

2018

Ann Clin Anal Med

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An accidental ingestion of a foreign body is a common cause of presentation to the emergency department. While the majority of the ingested foreign bodies pass through the gastrointestinal tract without causing any sequels, long, rigid, and sharp objects can cause complications such as perforations or obstructions. Serious health problems such as substance dependence, schizophrenia, or anorexia should be questioned in these rarely observed cases. Such objects need to be removed surgically or endoscopically as soon as possible. Our paper presents the removal of an impacted table fork from the stomach by endoscopy under sedoanalgesia three days after the incident.

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Endoscopic management of foreign bodies in the upper gastrointestinal tract: a retrospective study of 1294 cases

Abstract: Delayed flexible endoscopy in patients, especially elderly patients, with sharp FB impactions in the esophagus results in worse endoscopic outcomes. Endoscopic management under general anesthesia did not improve the therapeutic results compared with topical pharyngeal anesthesia.

Cited by 67 publications

References 21 publications

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

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

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

Endoscopic extirpation of a fork after three days; Case report and review of the literature

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