Foreign bodies in upper gastrointestinal tract and urgent endoscopic interventions – review of a ten-year period

  • Pavel Skok
  • Andreja Ocepek
  • Davorin Ćeranić
  • Milan Pocajt
Keywords: foreign bodies, upper gastrointestinal tract, endoscopy, extraction, complications

Abstract

Background: Foreign bodies in the upper digestive tube are rarely the cause of an urgent condition in gastroenterology. They usually enter the digestive tube during nutrition or by mistake. However, certain groups of the population such as convicts or psychiatric patients tend to swallow them intentionally. The authors aim was to assess the percentage of patients in which urgent endoscopic investigation revealed true foreign bodies in the upper digestive tube, to evaluate the success of endoscopic procedures and the resolution of eventual complications.

Patients and methods: The study includes patients in which urgent endoscopic investigations of the upper digestive tract were performed in a 10-year period (1 January 1994 to 31 December 2003).

Results: Altogether 6416 patients were investigated, mean age 59.3 years, SD ± 17.2 years, range 1–106 years, 2452 females and 3964 males. In 51 patients, 0.8% of all subjects, foreign bodies were detected in the esophagus or stomach. In these patients a total of 65 endoscopic investigations were performed, in 94% the foreign bodies were removed endoscopically (48/51 patients), in three cases the endoscopic procedures were not successful. Among the foreign bodies removed were various metal or plastic objects: coins, keys, screws, hooks, batteries, razor blades, needles, parts of kitchen, toilet or writing utensils, lighters, buttons, toys, a toothbrush as well as impacted pieces of bone. In the patients with successful endoscopic removal of the objects, no significant complications were noted. In 3 patients (3/48, 6.3%) only mild hemorrhages from the region of the esophagogastric junction were observed.

Conclusions: The technological development of endoscopic instruments made it possible to carry out different therapeutic procedures. The method has proved successful in removing foreign bodies from the upper digestive tube. Various factors affect the success of the procedure, the more important being adequate equipment, the experience and patience of the investigator and the assisting nurse, as well as the patient’s understanding of the procedure and his or her cooperation.

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References

Mariani PJ, Wagner DK. Foley catheter extraction of blunt esophageal foreign bodies. J Emerg Med 1986; 4: 301–6.

Taylor RB. Esophageal foreign bodies. Emerg Med Clin North Am 1987; 5: 301–11.

Chung RS. Removal of foreign bodies. In: Chung RS, ed. Therapeutic endoscopy in gastrointestinal surgery. New York: Churchill Livingstone; 1987. p. 227–42.

Webb WA. Management of foreign bodies of the upper gastrointestinal tract. Gastroenterology 1988; 94: 204–16.

Witzel L. Fremdkörper. In: Hahn RG, Riemann JF, eds. Klinische Gastroenterologie. Stuttgart, New York: Georg Thieme Verlag; 1996. p. 656–9.

Sanowski R, Harrison EM, Young M, Berggreen PJ. Foreign body extraction. In: Sivak MV, ed. Gastroenterologic endoscopy. Philadelphia: WB Saunders Company; 2000. p. 801–11.

Skok P. Nenadna bolečina v prsih – nujno stanje tudi v gastroenterologiji. In: Bručan A, Gričar M, Klančar S, Fink A, eds. Urgentna medicina: Izbrana poglavja. Ljubljana: Slovensko združenje za urgentno medicino; 2001: 255–7.

Brady P. Esophageal foreign bodies. Gastroenterol Clin N Am 1991; 20: 691–701.

Duncan M, Wong RKH. Esophageal foreign bodies. Gastroenterol Clin N Am 2003; 32: 1043–52.

Hyman FN, Klontz KC, Tollefson L. Food and drug administration surveillance of the role of foreign objects in foodborne injuries. Public Health Rep 1993; 108: 54–9.

Zamir D, Goldblum C, Linova L, Polychuck I, Reitblat T, Yoffe B. Phytobezoars and trichobezoars: a 10-year experience. J Clin Gastroenterol 2004; 38: 873–6.

Rimar Y, Babich JP, Shaoul R. Chewing gum bezoar. Gastrointest Endosc 2004; 59: 872.

Kikoler DJ, Duberstein DL, Zagoren AJ, Rozeboom E. A large accumulation of metallic foreign bodies in the stomach. J Am Osteopath Assoc 1992; 92: 657–60.

Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc 1995; 41: 39–51.

Velitchkov NG, Grigorov GI, Losanoff JE, Kjossev KT. Ingested foreign bodies of the gastrointestinal tract: retrospective analysis of 542 cases. World J Surg 1996; 20: 1001–5.

Stack LB, Munter DW. Foreign bodies in the gastrointestinal tract. Emerg Med Clin North Am 1996; 14: 493–521.

Quinn PG, Connors PJ. The role of upper gastrointestinal endoscopy in foreign body removal. Gastrointest Endosc Clin North Am 1994; 4: 571–93.

Ben Rejeb A, Gammoudi A, Ben Alaya M. Intestinal perforation by a fish bone. Apropos of a case and review of the literature. Ann Chir 1993; 47: 68– 70.

Guber MD, Suarez CA, Greve J. Toothpick perforation of the intestine diagnosed by a small bowel series. Am J Gastroenterol 1996; 91: 789–91.

Skok P. A razor blade in the stomach – an unusual cause of upper gastrointestinal tract hemorrhage. Endoskopie Heute 1998; 11: 5–7.

Skok P. Sengstaken tube: Useful also in removing sharp foreign bodies from esophagus – a case report. Endoskopie Heute 2001; 14: 107–9.

Skok P. Dried bay leaf: an unusual cause of upper gastrointestinal tract hemorrhage. Endoscopy 1998; 30: S40–1.

Jeen YT, Chun HJ, Song CW, et al. Endoscopic removal of sharp foreign bodies impacted in the esophagus. Endoscopy 2001; 33: 518–22.

Chaves DM, Ishioka S, Felix VN, Sakai P, Gama-Rodrigues JJ. Removal of a foreign body from the upper gastrointestinal tract with a flexible endoscope: a prospective study. Endoscopy 2004; 36: 887–92.

Ulmer BJ, Hansen JJ, Everley CA, Symms MR, Chadalawada V, Liangpunksakul S, et al. Propofol versus midazolam/fentanyl for outpatient colonoscopy: administration by nurses supervised by endoscopist. Clin Gastroenterol Hepatol 2003; 1: 425–32.

Yussoff IF, Raymond G, Sahai AV. Endoscopist administered propofol for upper gastrointestinal EUS is safe and effective: A prospective study in 500 patients. Gastrointest Endosc 2004; 60: 356–60.

Lightdale JR. Sedation and analgesia in the pediatric patient. Gastrointest Endosc Clin N Am 2004; 14: 385–99.

Požar N, Oroszy D. Premedikacija, anestezija in nadzor bolnika za endoskopske posege. Gastroenterolog 2004; 8 Suppl 2: 225–9.

Furihata M, Tagaya N, Furihata T, Kubota K. Laparoscopic removal of an intragastric foreign body with endoscopic assistance. Surg Laparosc Endosc Percutan Tech 2004; 14: 234–7.

How to Cite
1.
Skok P, Ocepek A, Ćeranić D, Pocajt M. Foreign bodies in upper gastrointestinal tract and urgent endoscopic interventions – review of a ten-year period. ZdravVestn [Internet]. 1 [cited 19Oct.2019];74(7-8). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/2123
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Case report

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