Differences between intentional and accidental ingestion of foreign body in China

Ye Zong,Haiying Zhao,Ming Ji,Yongjun Wang,Can Sun,Shutian Zhang,Yongdong Wu

doi:10.1186/s12876-020-01224-z

Ye Zong, Haiying Zhao + Show 5 more

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https://doi.org/10.1186/s12876-020-01224-z

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Abstract

BackgroundsPrevious reports of foreign-body ingestion focused primarily on accidental ingestion and very few studies focused on intentional ingestion of foreign body (FB) in China. Our study aimed to compare the prevalence of different age, gender, types, locations and management of FB ingested between intentional ingestion and accidental ingestion of FB in Northern China.MethodsA retrospective case series studied all patients with suspected FB ingestion in Digestive Endoscopy Center of Beijing Friendship Hospital, between January 2011 and January 2019. The patients were divided into 2 groups. Group A included the patients who intentionally ingested FBs, and Group B included the patients who accidentally ingested FBs. Patients’ database (demographics, past medical history, characteristics of FB, endoscopic findings and treatments) were reviewed. Statistical analyses were conducted using SPSS software.ResultsGroup A consisted of 77 prisoners, 2 suspects and 11 psychologically disabled persons. Group B consisted of 1020 patients with no prisoners, suspects or psychologically disabled persons. In Group A, there were no food-related foreign bodies, and the majority of FBs were metallic objects (54.44%). However in Group B, food-related FBs were the most common (91.37%). In Group A, 58 cases (64.44%) were located in the stomach, while in Group B, 893 cases (87.55%) were located in the esophagus (P < 0.05). 1096 patients successfully underwent endoscopic removal and 14 failed, including 9 cases in Group A and 5 cases in Group B. The duration of FBs impaction was longer in Group A than that in Group B (P < 0.05).ConclusionsIn our study, the patients who intentionally ingested FB were mainly prisoners, FBs were mostly sharp metallic objects, the duration of FBs impaction was longer, and the rate of successful endoscopic treatment was lower than that of the general population. Attention should be focused on these patients.

Highlights

Foreign body (FB) ingestion, including food bolus impaction, is a common clinical problem in China [1, 2]
The patients whose FBs had passed through the ligament of Treitz or the patients with perforation before endoscopic treatment were not referred to the Digestive Endoscopy Center
The patients were divided into 2 groups, Group A consisted of patients with intentional ingestion of FBs, and Group B consisted of patients with accidental ingestion of FBs

Summary

Introduction

Foreign body (FB) ingestion, including food bolus impaction, is a common clinical problem in China [1, 2]. Ingestion of FB by adults is generally accidental, the intentional ingestion of FB occurs in some adults such as prisoners [3], patients with psychiatric disorders or mental retardation. European guidelines reported that 80–90% of ingested FBs can spontaneously pass through the gastrointestinal tract, while 10–20% of ingested FBs may need to be removed endoscopically [4]. The patients who intentionally ingested FB form a special group. The study reported that the most commonly intentionally ingested objects included razor blades, batteries, and other sharp metallic items, which were not usually reported in the general population, and there was a greater demand for endoscopic and surgical interventions [6]

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