Background and Study Aims: Ingestion of foreign bodies is a common occurrence. Few papers in the literature
report experience and outcome at tertiary centers. The aim of this paper is to report
the management and the outcomes in 414 patients admitted for suspected ingestion of
foreign body between May 1995 and December 1999.
Methods: A plain radiographic film of the neck, chest or abdomen was obtained in the case
of radiopaque objects, and in order to rule out suspected perforation: in such cases
a computed tomography (CT) study was also performed. All patients were asked to give
their informed consent, which was refused by three patients. Anesthesia was always
used, either conscious sedation (86.8 %), or general anesthesia in the case of poor
patient tolerance (13.2 %). All patients underwent an endoscopic procedure within
six hours of admission. A flexible scope was used in all patients and a wide range
of endoscopic devices was employed.
Results: Foreign bodies were found in 64.5 % of our patients. Almost all were found in the
esophagus. The types of foreign body were very different, but they were chiefly food
boluses, bones or cartilages, dental prostheses or fish bones. In three patients (1.1
%) it was impossible to endoscopically remove the foreign body, which was located
in the cervical esophagus: all these three patients required surgery. No complications
relating to the endoscopic procedure were observed, but 30.7 % of patients had an
underlying esophageal disease, such as a stricture. Only eight patients required a
second endoscopic procedure, performed by a more experienced endoscopist.
Conclusion: Foreign body ingestion represents a frequent reason for emergency endoscopy. The
endoscopic procedure is a successful technique which allows the removal of the foreign
bodies in almost all cases without significant complications. Surgery is rarely required.
References
Linee guida in tema di ingestione di sostanze caustiche e di corpi estranei. In: Balzano A, Mosca S (eds.) Emergenze in gastroenterologia. Rome; II Pensiero
Scientifico 1998: 11-24 in vivo study.
Gastrointest Endosc.
1997;
45
490-492
samo@inwind.it
