EGS SO17 - Foreign body management - Time for improvement

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Abstract Background The management of foreign bodies (FBs) in clinical practice presents significant challenges across various medical specialties. FBs can be ingested, inhaled, inserted, or result from trauma, necessitating a comprehensive understanding of their management to prevent complications. The prevalence of FB incidents varies by age, with children being particularly susceptible to ingestion and inhalation, while adults often encounter FBs through trauma or occupational hazards. Effective management strategies are crucial to minimize morbidity and mortality associated with FB incidents. Method This study retrospectively reviewed cases of FB management over eight years (2015-2023), encompassing various specialties including gastroenterology, upper gastrointestinal and colorectal surgery. Data were collected on patient demographics, type and location of FB, method of removal, complications, and outcomes. Imaging techniques, such as X-rays, CT scans, and endoscopic evaluations, were analysed for their efficacy in FB detection. Different removal techniques, including endoscopic, surgical, and non-invasive methods, were evaluated for success rates and associated complications. Results Of the 153 FB incidents,47% involved male patients and 53% involved female patients.The paediatric group accounted for 36% of incidents.Non-invasive management was successful in 62% of cases,while 37% required invasive procedures.Among invasive interventions,70% required operative intervention,10% endoscopic intervention and 20% other minimally invasive options.The time to intervention for invasive procedures varied with more than 50% taking place after 24 hours.For operative interventions,64% occurred over 24 hours after presentation,21% within less than 24 hours, and 14% within 12 hours.All endoscopic interventions were performed within 12 hours.Outcomes showed that 96% of cases were managed without further complications.There were no reported mortalities. Conclusion Effective management of FBs requires a timely and appropriate intervention strategy tailored to the patient’s age and the type of FB. Non-invasive methods successfully managed most cases, while invasive procedures were necessary for a significant proportion. Prompt intervention, particularly endoscopic and other minimally invasive techniques, was associated with favorable outcomes and minimal complications. No mortalities were reported, underscoring the efficacy of current management protocols. Further research is needed to optimize these protocols and improve outcomes across diverse patient populations.