Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract: A Review of the Literature.

Mikhael Bekkerman,Amit H Sachdev,Yitzhak Twersky,Shahzad Iqbal,Javier Andrade

doi:10.1155/2016/8520767

Abstract

Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. Distinct foreign bodies predispose to particular locations of impaction in the gastrointestinal tract, commonly meat boluses in the esophagus above a preexisting esophageal stricture or ring in adults and coins in children. Several other groups are at high risk of foreign body impaction, mentally handicapped individuals or those with psychiatric illness, abusers of drugs or alcohol, and the geriatric population. Patients with foreign body ingestion typically present with odynophagia, dysphagia, sensation of having an object stuck, chest pain, and nausea/vomiting. The majority of foreign bodies pass through the digestive system spontaneously without causing any harm, symptoms, or necessitating any further intervention. A well-documented clinical history and thorough physical exam is critical in making the diagnosis, if additional modalities are needed, a CT scan and diagnostic endoscopy are generally the preferred modalities. Various tools can be used to remove foreign bodies, and endoscopic treatment is safe and effective if performed by a skilled endoscopist.

Highlights

Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world
Despite the fact that most foreign bodies pass spontaneously, there is still significant morbidity and mortality associated with retained foreign bodies, with some reports estimating that nearly 1500 deaths occur in the United States annually due to foreign body ingestion [3]
Beyond physical damage from the battery, complications have arisen where the battery was found to cause an esophageal stricture with the foreign body lodged in the esophagus surrounded by a mucus membrane, and, they have even been reported to pass through the esophageal wall and remain lodged within the mucosa [12]

Summary

Introduction

Foreign body ingestion is a common diagnosis that presents in emergency departments throughout the world. The most common types of foreign objects ingested (Table 1) differ between children and adults and each group may present with a unique set of symptoms [1, 3,4,5]. The type of foreign body ingested may predispose patients to a particular site of impaction as well as common patterns of complications (see “Common Sites of Impaction of Sharp Objects Occur at Acute Angles or Intestinal Narrowing”). Common Sites of Impaction of Sharp Objects Occur at Acute Angles or Intestinal Narrowing. Symptoms regularly present as odynophagia, dysphagia, sensation of having an object stuck, chest pain, and nausea/vomiting in descending order [9, 10] (see “Clinical Presentations of Foreign Body Impaction”).

Epidemiology and the Types of Foreign Bodies

Complications of Foreign Body Impaction

Diagnosis

Endoscopic Management and Surgical Intervention

Findings

Conclusions