IMAGING CHARACTERISTICS AND PREDICTIVE FACTORS OF COMPLICATED GASTROINTESTINAL FOREIGN BODIES IN COMPUTED TOMOGRAPHY

Abstract

Background: Gastrointestinal foreign body is a frequently encountered problem in daily practice at the Emergency Department. The majority of gastrointestinal foreign bodies will pass spontaneously, but in several cases, severe or even fatal complications can happen. X-rays, endoscopy, and computed tomography are the most common imaging modalities to diagnose gastrointestinal foreign bodies. Method: In our study, twenty-five patients who were diagnosed by CT and treated for gastrointestinal foreign bodies were reviewed retrospectively. The predictive risk factors for complications after foreign body ingestion or insertion were analyzed by multivariate logistic regression, including age, sex, type of gastrointestinal foreign body, and imaging characteristics in CT (location, size, thickening and enhancing bowel wall, fat infiltration, collection, and free gas). Results: All foreign bodies were sharp-pointed, and the average length was 30.56 ± 10.03 mm (11-54 mm). Bones accounted for 64% of cases, toothpicks followed with 16%. The most common location for foreign bodies in digestive tract was the small intestine, followed by the stomach, esophagus, and colon. Thickening and enhancing bowel wall, fat infiltration were both seen in most cases of 84%. Transmural foreign bodies accounted for 56% and perforation, abscess were more frequent complications with 64%, and 16% of cases, respectively. Multivariate analysis showed that size (p < 0.014) and type (p < 0.035) were significant independent risk factors associated with the development of complications in patients with gastrointestinal foreign bodies. Conclusion: CT plays a crucial role in the detection and diagnosis of gastrointestinal foreign bodies and its complications. In patients with gastrointestinal foreign bodies, the risk of complications was increased with bone type and larger size of foreign bodies.