Predictors of Recurrent Ingestion of Gastrointestinal Foreign Bodies

Abstract

1Department of Medicine; Division of Gastroenterology and Hepatology; 2Department of Biostatistics and Medical Informatics, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA. Correspondence: Dr Patrick R Pfau, Division of Gastroenterology and Hepatology, University of Wisconsin Hospital and Clinics, 4241 MFCB, 1685 Highland Avenue, Madison, Wisconsin 53705, USA. Telephone 608-263-4033, e-mail prp@medicine.wisc.edu Received for publication January 13, 2012. Accepted August 12, 2012 Gastrointestinal (GI) foreign body ingestions, comprised of foreign objects and food impactions, occur frequently and are a common endoscopic emergency. Although the vast majority of GI ingestions do not result in serious clinical sequelae or mortality (1), it has been estimated that 1500 to 2750 patients die annually in the United States from the ingestion of foreign bodies (2-4). More recent studies have suggested the mortality from GI foreign bodies to be significantly lower, with no deaths reported in more than 500 adults and one death in approximately 1200 children with a GI foreign body (5,6). Small studies have shown that intentional ingestion of foreign bodies occurs with higher frequency in certain subgroups such as prisoners and individuals with psychiatric illnesses (7,8). The majority (80% to 90%) of ingested foreign objects and food bolus impactions will pass spontaneously without clinical sequelae (1). However, 10% to 20% of GI foreign bodies require endoscopic intervention (9-11). Currently, the overwhelming majority of foreign body literature is descriptive (types and location of foreign bodies) and there is a paucity of literature attempting to identify individuals at risk for recurrent foreign body ingestion. If a specific population could be identified as ‘high risk for recurrence’, then certain measures could be directed at preventing another ingestion event. Thus, the primary aim of our study was to identify predictors of recurrent ingestion among a retrospective cohort of patients presenting with GI foreign bodies.