Factors associated with development of complications after endoscopic foreign body removal

Abstract

Background/Aims:We analyzed the clinical characteristics of patients who underwent endoscopic foreign body removal and the risk factors of complications.Patients and Methods:The medical records of 415 patients treated from January 2000 to August 2011 for suspected foreign bodies were retrospectively reviewed. Patient characteristics, endoscopic findings, clinical outcomes, and risk factors of complications were analyzed.Results:Foreign bodies were detected endoscopically in 315 patients. Fish bone fragment (36.9%) and coins (15.3%) were the most common type of foreign bodies in adults and children, respectively. Complications associated with endoscopic procedure occurred in 26 patients (8.3%); 20 of the patients were treated conservatively and the other six patients underwent surgical treatment. Perforation (14%) was the most common complication. By univariate and multivariate analysis, the risk factors associated with complication after endoscopic foreign body removal were long duration from ingestion to endoscopy (P = 0.009) and existence of initial mucosal injury (P = 0.018).Conclusions:Most foreign bodies were successfully removed by endoscopy without complication, but long duration from ingestion to endoscopy and mucosal injury were risk factors of complications of endoscopic foreign body removal. Patients with these risk factors could require more careful treatment.

Endoscopic foreign body removal in the upper gastrointestinal tract: risk factors predicting conversion to surgery

“…In the series of 316 esophageal foreign bodies reported by Sung et al analyzing similar complications, the independent risk factors identified were duration of impaction over 24 h, bone-type foreign bodies, and size over 30 mm [23]. In other domestic studies, sharp foreign bodies, long diameter, severe symptoms, longer duration, and existence of initial mucosal injuries were risk factors predicting complications related to the removal of the foreign bodies [10,24]. Although most large series assessing risk factors for complications are from Asia (with different foreign body types relative to the Western World) and retrospective, it is likely that the key messages are not significantly different each other.…”

“…By contrast, the complication rate jumped up to 36.3 % when endoscopy was performed later than 24 h after ingestion. The complication rate associated with endoscopic removal has been reported to range from 0 to 38 %, depending on what is considered as a complication (such as mucosal erosions in some series) [10,[19][20][21][22]. In a retrospective study of 1338 patients from Hong Kong with a complication rate of 2.8 %, the independent risk factors of complications were presentation over 2 days, positive cervical radiographic findings, and impaction above the mid-esophagus [15].…”

“…According to the American Society for Gastrointestinal Endoscopy, only 10-20 % of foreign bodies may need to be removed endoscopically [4,8]. However, in recent years, several reports have emerged indicating that the rate at which endoscopic treatment was performed was higher, especially in eastern countries [9,10]. The reason is presumably that the procedure is popular and accessible almost anywhere, and it may not only confirm the diagnosis, but may also rule out foreign body ingestion/impaction, or provide definite treatment [11].…”

Esophageal foreign body ingestion in adults on weekdays and holidays

“…Some studies have shown that long duration from ingestion to endoscopy and mucosal injury were risk factors of complications of endoscopic FB removal. [ 31 ] On the contrary, Huang et al [ 32 ] have shown that longer wait times are not associated with mucosal injury or postoperative complication. Given the study participants consisted of children, which was different from other researches, more data need to be collected to support this view.…”

A Timely Intervention: Endoscopic Retrieval of a Swallowed Magnetized Activity Watch

“…The device is advertised as being waterproof to 50 meters; however, this did not allay the surgeon or patients' concern for battery exposure and the risk of a caustic perforation [ 12 ]. Several studies have shown that sharp foreign bodies, severe symptoms, long duration from ingestion to endoscopy, and existence of mucosal injury are significant risk factors predictive of complications related to removal of foreign bodies [ 14 , 15 ]. We believe that early detection and a timely endoscopic removal were two factors that contributed to successful retrieval for this case.…”