Approach to foreign bodies in the upper Gastrointestinal system

Mustafa Şentürk,Halil Özer,Yusuf Yavuz

doi:10.21601/ortadogutipdergisi.545267

Abstract

Objective: The aim of this study is to reveal the clinical presentations and treatment approaches to the patients applied with foreign body ingestion and food residue accompanied by literature. Materials and Methods: Patients who were admitted to the general surgery clinic of Ceylanpinar State Hospital between March 2018 and March 2019 with the suspicion of ingestion of foreign bodies in the upper gastrointestinal tract and food residue were evaluated retrospectively. Findings: The mean age of our patients was 31.3 (min-max: 18-76). Endoscopy without sedation was performed to 3 patients (37.5%) due to the feeling of stuck. In 2 patients, the bone fragments detected in the esophagus were excised with the help of endoscopic forceps. One of the three endoscopic procedures have failed. Patient whose endoscopy was unsuccessful and five other patients were followed-up medically in order to let foreign bodies or food residues to leave the digestive tract spontaneously. None of the patients had esophageal disease or a known psychiatric disorder. The mean duration of admission to the hospital was 12.5 (min-max: 6-36) hours. Three patients (37.5%) had foreign body feeling and dysphagia. Four of the patients (50%) had foreign bodies and the rest of the patients had food residue. The localization of foreign bodies or food residues were detected as; stomach in 1 patient (12.5%), esophagus in 3 patients (37.5%) and intestines in other 4 patients (50%). None of the patients required surgical intervention. Conclusion: In the early period, endoscopic procedures show a high success rate without complications in the treatment of foreign bodies in the upper gastrointestinal tract. However, it is an appropriate approach to wait for the spontaneous exit of the foreign body in cases that the foreign body have already passed the upper gastrointestinal system.

Highlights

Foreign body ingestion and food residues are one of the conditions that will cause significant morbidity and mortality if not treated adequately
We present our clinical experiences and analyzed the clinical presentation of the patients applied to the general surgery clinic of the Ceylanpinar State Hospital due to foreign body ingestion
Patients who were admitted to Ceylanpinar State Hospital General Surgery Clinic between March 2018 and March 2019 with suspicion of foreign body ingestion and food residue were evaluated retrospectively

Summary

Introduction

Foreign body ingestion and food residues (animal bones) are one of the conditions that will cause significant morbidity and mortality if not treated adequately. It is estimated that 1,500-1,600 patients die in the United States of America every year due to complications associated with ingestion of foreign bodies into the gastrointestinal tract [1]. The majority of ingested foreign bodies can pass spontaneously from the gastrointestinal tract, but 20% require endoscopic or surgical treatment [2,3]. In patients with bowel malformations and gastrointestinal system surgery history, the incidence of foreign body complications is higher [6]. The need for radiological examination before endoscopy is determined according to the type, size and shape of the foreign body. The endoscopic method to be used to remove the foreign body is generally determined according to physical examination, symptoms and complications [7]. We present our clinical experiences and analyzed the clinical presentation of the patients applied to the general surgery clinic of the Ceylanpinar State Hospital due to foreign body ingestion

Methods

Results

Conclusion