Gastric Foreign Body Research Articles

Detection of foreign bodies in the canine stomach using capsule endoscopy: a randomized trial.

This study aimed to assess the effectiveness of capsule endoscopy in detecting gastric foreign bodies in normal dogs, considering variations in the number of foreign bodies and the gastric environment. Five healthy male beagles were administered virtual, non-harmful foreign objects that maintained their shape in the stomach. Capsule endoscopy was performed and the images were evaluated by veterinarians and non-veterinarians. The overall sensitivity and specificity of capsule endoscopy were 99.1 and 90.4%, respectively. Sensitivity and specificity were comparable between veterinarians and non-veterinarians. Sensitivity and specificity in the veterinarian group were 98.7 and 91.2%, respectively, whereas those in the non-veterinarian group were 100 and 88.5%, respectively. Capsule endoscopy is a valuable alternative diagnostic tool for identifying foreign bodies in the stomach, particularly in challenging cases in which conventional imaging or invasive approaches have limitations.

Gastrotomy for removal of a gastric fishhook foreign body in a blue catfish (Ictalurus furcatus)

AbstractAn adult blue catfish (Ictalurus furcatus) presented for ingestion of a fishing lure. Manual retrieval of the fishing lure was attempted via palpation of the stomach through the oral cavity and oesophagus. The lure was palpable within the lumen of the stomach, but it could not be safely extracted, as one of the treble‐barb hooks on the lure had perforated the gastric wall. The lure was surgically removed via gastrotomy. Six weeks following surgery, the patient experienced dehiscence of the skin incision, which was left open for healing by second intention. The patient made a complete recovery. This is the first documented gastrotomy for successful removal of a gastric fishhook foreign body in a teleost fish.

Rapunzel syndrome in children: a retrospective review of ten cases combined with literature review in a tertiary referral center.

Rapunzel syndrome is an uncommon condition in children, and its clinical features remain unclear. This study presents the largest single-center series of pediatric cases to date, with the objective of documenting the clinical characteristics and treatment approaches for children with Rapunzel syndrome. A retrospective study was conducted in children with Rapunzel syndrome from 2019 to 2023. We recorded age, gender, symptoms, locations of bezoar, complications, and treatment options. Ten patients with Rapunzel syndrome were included. The median age was 9.1years, with all of whom were female. The most common clinical symptoms were upper abdominal mass (90%), abdominal pain (80%), and nausea and vomiting (50%). Complications occurred in six cases (60%), including small bowel obstruction (20%), severe gastric dilatation (10%), intestinal perforation (10%), choledochodilation (10%), acute pancreatitis with cholecystitis (10%). Preoperative ultrasonography suggested low-echoic foreign bodies continuing to the jejunum or ileocecal region in five cases (50%). Preoperative gastroscopy attempted in four cases (40%) to remove the foreign bodies, all of which failed. All patients underwent surgical treatment, with nine cases undergoing gastric incision foreign body removal, and one case undergoing gastric incision foreign body removal combined with intestinal perforation repair. All patients recovered well. No recurrence was observed during follow-up. The accuracy of ultrasound diagnosis in identifying Rapunzel syndrome is high; however, it may lead to misdiagnosis if not complemented with the patient's medical history. Endoscopic presents a heightened treatment risk and a reduced success rate. The condition commonly presents with severe complications, thus making laparotomy a safe and effective option for intervention.

Diagnosis and treatment of gastric foreign body (earrings) case in a cat

In this study, information was given about the diagnosis and treatment of a 2-month-old female cat that was admitted to the clinic with the complaint of swallowing a foreign body (earring). The medical history of the case indicated that the cat had a good appetite and defecated normally. Abdominal palpation showed a distended stomach. No clinical findings other than the distended stomach were noted during clinical examination. Radiographic examination revealed a foreign body with hyperechoic contrast in the stomach. Due to the presence of a penetrating foreign body, it was decided to urgently perform an operation. For the operation, the cat was anesthetized with xylazine and ketamine. The foreign body (earring) in the stomach was removed from the body by gastrotomy. Special diet and parenteral antibiotics were applied to the patient in the postoperative period. During the interviews with the owner on the 15th postoperative day, it was learned that the cat continued its normal life.

Endoscopic Removal of Gastric Foreign Bodies with a Bottle Liner in 12 Dogs (2020-2023).

Endoscopy is widely used to remove gastric foreign bodies using grasping forceps and loop snares to manipulate and retrieve the foreign material. However, as not all foreign bodies can be removed using conventional endoscopic techniques, this case series describes the use of bottle liners for the removal of gastric foreign bodies in 12 dogs between 2020 and 2023. A 4 oz bottle liner (Drop-Ins) was placed at the end of the endoscope and pushed into the stomach. With the help of forceps introduced into the operating channel, the foreign body was pushed into the bottle liner. The bottle liner containing the foreign body was then extracted with the help of traction threads. The technique was used as the initial retrieval method in 5 dogs because of smooth (i.e., difficult to grasp) or sharp (i.e., that may damage the digestive tract mucosa during removal) foreign bodies and as a rescue procedure in 7 dogs. Foreign body retrieval was successful in all 12 dogs, with minor complications reported in 5 dogs (erosions and bleeding of the gastroesophageal sphincter). The use of a bottle liner represents an affordable alternative to gastrotomy when foreign bodies cannot be grasped with forceps or snares.

Gastric foreign body granuloma resembling gastric cancer: a case report

Fishbones are frequently swallowed by foreign objects that can penetrate the gastrointestinal tract. Nonetheless, it is quite uncommon for these fishbones to become lodged within the tract, resulting in the formation of foreign body granulomas that resemble submucosal tumors. When encountering this situation, it's important to consider differential diagnoses such as gastric intestinal stromal tumor, gastric leiomyoma, and gastric neurofibroma. We present a case of gastric foreign body granuloma that presents with dull aching epigastric pain. The patient gave a vague history of displaced intrauterine contraceptive devices (IUCD). Contrast CT and PET scan showed a gastric antral mass possibly a gastric cancer or a migrating IUCD. Endoscopic ultrasound (EUS) suggested a perigastric foreign body reaction due to the presence of a linear echogenic structure in between the markedly thickened gastric antral wall and the right lobe of the liver. EUS-guided fine needle biopsy (EUS-FNB) revealed non-specific inflammatory reaction. Afterward, surgical exploration unveiled the cause of the mass as a foreign body granuloma caused by a perforating fishbone.

Endoscopic Retrieval of Esophageal and Gastric Foreign Bodies in Cats and Dogs: A Retrospective Study of 92 Cases.

Esophageal and gastric foreign bodies (FBs) commonly occur in small animal practices, and their endoscopic removal has been previously reported. However, few studies reported the endoscopic instruments used for the retrieval attempt and the time spent for endoscopic removal. Therefore, the aim of this study is to evaluate the factors that can influence the success rate and timing of the endoscopic retrieval of FBs. The medical records of 92 animals undergoing endoscopic removal of esophageal (n = 12) and gastric (n = 84) FBs have been reviewed. Two dogs had FBs in both the esophagus and stomach. From medical records and video recordings, there were extrapolated data on signalment, clinical signs, endoscopic devices used, success of retrieval, and duration of endoscopy. Endoscopic removal of FBs was successful in 88% cases, and the mean time spent for the extraction was 59.74 min (range, 10-120 min). The success rate and timing for the removal of endoscopic foreign bodies (EFBs) are influenced by several factors in our population: medium-breed dogs, adult animals, and localization of FBs in the body of the stomach increased the probability of failure during the endoscopic retrieval attempt. Conversely, the success and timing of the retrieval of EFBs were higher in puppies and with increasing operator's experience. Moreover, the use of combination devices such as polypectomy snare and grasping forceps negatively influenced the success of extraction of FBs. Further prospective and comparative studies in a large and multicentric population of patients can be useful to create interventional endoscopic guidelines, as in human medicine.

Conservative management of metallic sharp-pointed straight gastric and intestinal foreign bodies in dogs and cats: 17 cases (2003-2021).

To describe the conservative management and outcome of gastrointestinal metallic sharp-pointed straight foreign bodies in dogs and cats. Clinical records of dogs and cats presented to a university teaching hospital between 2003 and 2021 with gastrointestinal metallic sharp-pointed straight foreign bodies (e.g. needles, pins, nails) were reviewed. Conservative management was defined as leaving the foreign body in situ. Cases were excluded if the foreign body was identified outside of the gastrointestinal tract (including oropharynx and oesophagus) or if it was removed by endoscopy or surgery as the first treatment choice. Patient signalment, presenting complaint, foreign body location, treatment, complications, gastrointestinal transit time, length of hospitalisation and outcome were recorded. A total of 17 cases (13 dogs and four cats) were included in the study, being treated with primary conservative therapeutic approach (11) or following failure of endoscopy (two), surgery (three) or both (one). Clinical signs associated with the foreign body were reported in three (17.6%) cases. Conservative management was successful in 15 (88.2%) cases, with no complications reported. Patients were clinically and radiographically monitored with variable supportive care. In two (11.8%) cases, surgery was subsequently performed as the foreign body failed to progress on repeated radiographs after 24 hours. Mean foreign body gastrointestinal transit time for patients treated conservatively was 59.2 (±31.4) hours. All patients survived to discharge. Conservative management is a treatment option for clinically stable cats and dogs with metallic sharp-pointed straight gastrointestinal foreign bodies in the absence of perforation.

Diagnosis and surgical management of gastric and duodenal foreign bodies in a 15 month old male Alaskan husky: A case report

A 15 months old male Alaskan husky weighing 28 kg was presented to the hospital with a history of acute onset of frequent emesis and not passing stools which had persisted for 5 days, on physical examination animal was in dull mentation having lethargy and generalised malaise. Clinical examination revealed that prolonged capillary refill time and skin tenting time. Haemato-biochemical profile revealed mild granulocytosis and increased packed cell volume. Plain abdominal radiography revealed two large radiopaque foreign bodies in the stomach and proximal portion of intestinal loops. Immediately we performed exploratory laparotomy followed by gastrotomy, enterotomy and retrieved two large sized thick rubber objects which obstructed the stomach and a portion of duodenal lumen completely. The animal have shown an uneventful recovery after 1 week of proper postoperative care, fluid and antibiotic therapy.

COVID-19 pandemic and lockdown: what has changed in common home accidents such as foreign bodies and corrosive injuries?

BackgroundCOVID-19 pandemic greatly affected our lives in all areas. Due to the social isolation policies implemented during this period, the majority of parents and all school-age children spent their lives at home. This study aims to investigate the effects of pandemic and isolation on home accidents treated in our center.MethodsForeign body ingestion (gastric foreign bodies: G.FB), foreign body aspiration (respiratory foreign bodies: R.FB), and corrosive substance (CS) ingestion cases admitted to our hospital between March 11, 2019, and March 10, 2021, were retrospectively analyzed. Demographic data, type and cause of home accidents, the time of the accident and the admission to the hospital, the location of the foreign body, and the follow-up data were recorded. The patients were divided into two groups: the pre-pandemic period (11 March 2019–10 March 2020) and the COVID pandemic period (11 March 2020–10 March 2021), and the data were evaluated between two groups as < 6 years old and 6–18 years old.ResultsDuring the 2 years, a total of 982 patients were admitted to our hospital for G.FB, R.FB, or CS. Four hundred and eighty-three of them (49.2%) were in the pre-pandemic period and 499 (50.8%) were in the pandemic period (p = 0.206). The mean age of the patients was 3.63 ± 3.32 years; 82.4% of the patients in the pre-pandemic group and 85.4% of the patients in the pandemic group were children < 6 years old. While the F/M ratio was 1/1.5 during the pre-pandemic period, it was 1/1.1 during the pandemic period. Of the cases, 73.3% were G.FB, 4.6% were R.FB, and 22.1% were CS. Almost half of the accidents occurred between the hours of 16 and 24. During the pandemic period, the accidents increased to occur between 0 and 8 am in children < 6 years old, and between 8 am and 4 pm in children 6–18 years old (p = 0.003). All of the home accidents in the 6–18 age group between 0 and 8 o'clock were girls (p < 0.0001). During the pandemic period, the frequency of button batteries and food products increased in G.FB. Also, the frequency of R.FB increased significantly (p = 0.006) and the most common R.FB was the food products. The frequency of CS increased in girls during the pandemic period, and CSs were brought to the hospital in a shorter time after the accident during the pandemic period (p = 0.007).ConclusionsIt can be thought that the main reason why home accidents are common in the 0–6 age group is due to the developmental characteristics of the child rather than the longer time spent at home. The pandemic and isolation increase the frequency of foreign body aspirations and home accidents in girls.

Endoscopic extraction of a gastric foreign body by means of an esophageal self-expanding metal stent.

Endoscopic extraction of a gastric foreign body by means of an esophageal self-expanding metal stent.

Gastric Point-of-Care Ultrasound in Acutely and Critically Ill Children (POCUS-ped): A Scoping Review.

IntroductionPoint-of-care ultrasound (POCUS) use is increasing in pediatric clinical settings. However, gastric POCUS is rarely used, despite its potential value in optimizing the diagnosis and management in several clinical scenarios (i.e., assessing gastric emptying and gastric volume/content, gastric foreign bodies, confirming nasogastric tube placement, and hypertrophic pyloric stenosis). This review aimed to assess how gastric POCUS may be used in acute and critically ill children.Materials and MethodsAn international expert group was established, composed of pediatricians, pediatric intensivists, anesthesiologists, radiologists, nurses, and a methodologist. A scoping review was conducted with an aim to describe the use of gastric POCUS in pediatrics in acute and critical care settings. A literature search was conducted in three databases, to identify studies published between 1998 and 2022. s and relevant full texts were screened for eligibility, and data were extracted, according to the JBI methodology (Johanna Briggs Institute).ResultsA total of 70 studies were included. Most studies (n = 47; 67%) were conducted to assess gastric emptying and gastric volume/contents. The studies assessed gastric volume, the impact of different feed types (breast milk, fortifiers, and thickeners) and feed administration modes on gastric emptying, and gastric volume/content prior to sedation or anesthesia or during surgery. Other studies described the use of gastric POCUS in foreign body ingestion (n = 6), nasogastric tube placement (n = 5), hypertrophic pyloric stenosis (n = 8), and gastric insufflation during mechanical ventilatory support (n = 4). POCUS was performed by neonatologists, anesthesiologists, emergency department physicians, and surgeons. Their learning curve was rapid, and the accuracy was high when compared to that of the ultrasound performed by radiologists (RADUS) or other gold standards (e.g., endoscopy, radiography, and MRI). No study conducted in critically ill children was found apart from that in neonatal intensive care in preterms.DiscussionGastric POCUS appears useful and reliable in a variety of pediatric clinical settings. It may help optimize induction in emergency sedation/anesthesia, diagnose foreign bodies and hypertrophic pyloric stenosis, and assist in confirming nasogastric tube placement, avoiding delays in obtaining confirmatory examinations (RADUS, x-rays, etc.) and reducing radiation exposure. It may be useful in pediatric intensive care but requires further investigation.

Outcomes of esophageal and gastric bone foreign bodies in dogs.

BackgroundBone foreign bodies are commonly encountered in small animal practice. Esophageal bone foreign bodies (E‐bFBs) warrant removal, whereas gastric bone foreign bodies might not.ObjectivesDescribe management and outcomes for dogs with esophageal or gastric bone foreign bodies.AnimalsOne hundred twenty‐nine dogs with esophageal (n = 45) or gastric (n = 84) bone foreign bodies.MethodsRetrospective review of medical records.ResultsDogs with E‐bFBs were younger than dogs with gastric bone foreign bodies (median age esophageal, 4 years [IQR 2‐8]; median age gastric, 6 years [IQR 3‐10]; P = .03), and had a higher bone cross‐sectional area relative to body weight (median esophageal, 98.21 mm2/kg [IQR 48.25‐142.6]; median gastric, 28.6 mm2/kg [IQR 17.25‐64.28]; P < .001). Forty‐two of 45 esophageal foreign bodies were resolved non‐surgically and 3 by esophagotomy. Esophageal erosions were more likely with distal entrapment (OR 12.88, [95% CI 31.95‐129.29], P = .01) and longer duration (OR 18.82 [95% CI 2.22‐273.97], P = .01). Sixty‐two of 84 bone gastric foreign bodies were left in situ. Endoscopic removal was successful in 20 of 22 (91%; 95% CI 70‐99) attempts.Conclusions and Clinical ImportanceWhile all E‐bFBs were dislodged either by advancement into the stomach, endoscopic removal, or esophagotomy, the majority of gastric bone foreign bodies were left in situ for dissolution, with no reported complications. Gastric advancement of E‐bFBs should be considered when oral removal is not feasible, and dissolution can be considered even with large bones.

Инородные тела в желудке у ребенка 5 лет: особенности клинической симптоматики (клиническое наблюдение)

Gastrointestinal foreign bodies (FB) are a relevant issue of present-day pediatrics due to non-specific clinical presentations, difficulties in collecting medical history because of child’s age, and low awareness of parents and practitioners. The authors describe a 5-year girl with multiple gastric FBs (a conglomeration of hundred 0.3-cm magnetic balls). The girl was twice admitted to different hospitals with different incoming diagnoses. Non-specific clinical symptoms and complaints resulted in late diagnosis, primary exclusion of other infectious (acute gastroenteritis) and inflammatory (ulcerative colitis) GI disorders, and unreasonable prescription of medications including antibiotics. The authors address the management strategy for gastric magnetic FBs in this child and difficulties with their endoscopic removal. More than three weeks (24 days) had passed from the first symptoms to the final diagnosis. This case report illustrates the need for the accurate collection of medical history and timely diagnostic search using X-ray and endoscopic imaging irrespective of a child’s age. KEYWORDS: foreign bodies, gastrointestinal tract, children, magnetic balls, endoscopy, X-ray. FOR CITATION: Bevz A.S., Bokova T.A., Elin L.M. Gastric foreign bodies in a 5-year child: pattern of clinical presentations (case report). Russian Journal of Woman and Child Health. 2022;5(2):173–177 (in Russ.). DOI: 10.32364/2618-8430-2022-5-2-173-177.

Endoscopic extraction of a gastric submucosal foreign body after precise location with endoscopic ultrasound combined with endoscopic submucosal dissection.

Endoscopic extraction of a gastric submucosal foreign body after precise location with endoscopic ultrasound combined with endoscopic submucosal dissection.

Survey of Instruments and Techniques for Endoscopic Retrieval of Esophageal and Gastric Foreign Bodies in Cats and Dogs

Esophageal and gastric foreign bodies (EFB and GFB) are a common occurrence in cats and dogs. The objective of this study is to evaluate the endoscopic instruments and techniques used for foreign body retrieval by internists or criticalists based on type and location of the foreign body. An online, anonymous survey was created using a commercial software. The survey was distributed to diplomates of the ACVIM (SAIM) and ACVECC through each college's listserv. Data obtained included specialty, years in practice, practice type, available instruments, and preferred instrument for various foreign bodies by location and type. Two hundred sixty-eight surveys were completed with 74% from private referral practice and 21% from academic practice. For EFB, laparoscopic or endoscopic grasping forceps were used most commonly. For GFB, grasping forceps or loop snares were used most commonly. Fifty percent of respondents reported attempting duodenal FB removal. In practices with limited financial resources, endoscopic grasping forceps and loop snares may be prioritized for purchase as these instruments may have the most application for foreign body retrieval from the esophagus and stomach.

Gastric Foreign Bodies in Prison Inmates

Abstract Objective Gastric foreign bodies are a common problem brought to an endoscopist. Prisoners are more prone to ingesting unusual foreign bodies for a secondary gain. The objective of this study was to study the profile of foreign body ingestion among the prisoners brought to a tertiary care center. Methods This is a retrospective case series. All the prisoners brought for endoscopic removal of foreign bodies between January 2018 to December 2019 were included in the analysis. Patients’ baseline characteristics, type of foreign body, management, and outcome were noted Results A total of eight inmates presented with ingestion of foreign body to our department. Most common foreign bodies ingested were drug packets and mobile phones. All ingestions were for secondary gain. Endoscopic removal was successful in all cases. Conclusion Endoscopic removal can be tried with all necessary precautions by an expert endoscopist.

Recurrent trichobezoar in a patient with Rapunzel syndrome

Rapunzel syndrome is a condition where a trichobezoar is formed in the stomach and proximal intestine due to hair ingestion. A 6-year-old girl presented to emergency department with abdominal pain, vomiting and a palpable epigastric mass. Laparotomy was performed for gastric foreign body; a trichobezoar that filled the stomach, duodenum and proximal small intestine was removed. Postoperative course was uncomplicated; the patient was discharged for further out-patient follow-up and psychological care. After 7 months, the girl presented with a recurrence. A recurrent trichobezoar was removed via laparotomy. The girl was started on psychiatric treatment and iron substitution for anaemia. Ten weeks after discharge, follow-up gastroscopy was negative for gastric foreign body. There are no guidelines for follow-up after trichobezoar removal. Since the disease may be recurrent, follow-up endoscopy should be considered in order to enable an early diagnosis and less invasive treatment.

Gastric Bezoar: Retrieve it, Leave it, or Disbelieve it?

To determine the demographics, potential risk factors, endoscopic interventions and outcomes relating to gastric bezoars in pediatric patients; and comparing results with previously published literature. Retrospective series by chart review of patients identified by International Classification of Diseases-9 codes 938 and 935, using the following Medical Subject Headings: 1, term bezoar; 2, Keywords gastric bezoar∗ or gastric foreign body∗. Thirty pediatric patients between ages of 2 to 18 years were found with gastric bezoars, with a female predominance. Majority had a phytobezoar. Six patients were diagnosed with dysautonomia, implying possible role of autonomic dysfunction contributing to abnormal gastric retention. Frequent symptoms included abdominal pain, nausea and vomiting, a decrease in appetite, and unintentional weight loss. A higher prevalence of underlying gastrointestinal disorders was found in those with bezoars. Nuclear medicine gastric emptying scan performed in 13 children was significantly abnormal in only 4 of these children. Most patients were treated with endoscopic removal of the bezoar. Endoscopic removal was accomplished by Roth net, generally requiring multiple passes. At follow-up, most of the children had improvement of symptoms, with bezoar recurrence in 1 patient. This is to our knowledge the largest series of gastric bezoars in pediatrics. On the basis of our review, phytobezoars may be under-reported in pediatrics. Bezoars should be considered in children presenting with chronic abdominal pain, nausea, and vomiting; even in developmentally normal children and those with normal gastric emptying. We suggest that dysautonomia and underlying gastrointestinal disorders may be potential risk factors.

Desperate times call for desperate measures: non-food ingestion by starving seabirds

Food deprivation may decrease selectivity in food; however, (1) whether animals can cross a selectivity threshold whereby they ingest non-nutritive items ('non-food') in lieu of food (engaging in pica/lithophagia), (2) their behaviour, or (3) the implications of these behaviours are not documented. By examining carcasses of seabirds that ingested pumice of known provenance prior to death, we provide insights into whether wild animals starve because they have eaten non-food, or whether they eat non-food because they are starving. We investigated ingestion of pumice and plastic in carcasses of short-tailed shearwatersArdenna tenuirostrisfollowing a significant starvation mortality event (also known as seabird wreck), during which millions of shearwaters died along the eastern Australian coastline in 2013. We found that the stomachs of 96.5% of 172 seabirds sampled contained pumice or plastic at the time of death. We used global location sensors to track the 2013 shearwater migration and overlaid these tracks with the dispersing pumice raft from the 2012 Havre underwater volcanic eruption, Kermadec Islands, New Zealand. We determined that shearwaters in a starved state had ingested pumice 12-41 h before death, indicating that starving or food-stressed seabirds exhibit reduced prey discrimination. The provenance of the ingested plastic was not known. Ingestion of non-nutritive items has serious implications for wildlife, particularly long-lived or migrating species. Additional risk to already nutritionally compromised animals includes dietary dilution, gastric foreign body obstruction and toxicity. With a projected changing climate and increased marine pollution and over-exploitation of resources, this study has implications for the interaction of stressors, mass mortalities and exacerbation of existing threats to marine species.