Gastric Foreign Body Research Articles

Novel technique for endoscopic retrieval of a ring-shaped gastric foreign body

We present a novel technique for retrieval of a retained ring-shaped gastric FB that is accessible, safe, reliable and cost-effective.

An uncommon cause of abdominal mass: Phytobezoar

Phytobezoar is a gastric foreign body formed due to accumulation of ingested fruits and/or vegetables. Patients usually have a predisposing condition leading to alteration in gastric emptying. Altered gastric emptying leads to stagnation and amalgamation of the ingested vegetables or fruits. This condition can be easily diagnosed with upper gastrointestinal endoscopy. Management is medical if the size is small. Larger phytobezoars need endoscopic therapy. In this case report, we describe a case of phytobezoar in a middle aged lady with no known risk factor. She was managed successfully by therapeutic endoscopy.

Endoscopic and surgical removal of oesophageal and gastric fishhook foreign bodies in 33 animals.

To describe the location, retrieval, frequency of surgery and complications associated with fishhook foreign bodies. Retrospective evaluation of the medical records of cats and dogs admitted between 2010 and 2016 after fishhook ingestion. A total of 33 cases (2 cats and 31 dogs) were included. The most common locations were the proximal oesophagus [12/33 (36%)] and stomach [11/33 (33%)]. Endoscopic retrieval was successful in 27 of 33 cases (82%); oesophageal perforation was the only recorded complication, occurring in six of 33 (18%) cases. Surgery was performed in six cases (18%), and no early complications were recorded. The survival rate was 100%. The endoscopic removal of ingested fishhooks is highly successful. In the present study, survival to discharge was 100%, even in cases of oesophageal perforation or in cases requiring surgery.

Septic peritonitis secondary to a perforating gastric foreign body in an Irish Sport Horse gelding

SummaryA 17‐year‐old Irish Sport Horse gelding was referred to the University College Dublin Veterinary Hospital for low‐grade colic that had been nonresponsive to medical treatment. Diagnostic investigation revealed a marked septic peritonitis. The inciting cause was detected by gastroscopy to be a perforating foreign body in the pylorus of the stomach from a briar of a blackthorn plant (Prunus spinosa spp.). Successful removal of the foreign body was achieved surgically via gastrotomy. The horse subsequently developed a multi‐drug resistant abdominal incision site infection, which was successfully managed over a 2‐month period. Abdominal incisional herniation occurred thereafter. Six months post‐operatively, the horse was back in light work and no further adverse sequelae had been noted.

Video-assisted thoracic surgery for the management of pyothorax in dogs: 14 cases.

To report the perioperative findings and outcome of dogs undergoing video-assisted thoracic surgery (VATS) for the management of pyothorax. Multi-institutional, retrospective study. Client-owned dogs (n = 14). Medical records of dogs with pyothorax managed via VATS were reviewed for signalment, history, clinical signs, clinicopathological findings, diagnostic imaging results, surgical variables, bacterial culture and sensitivity results, post-operative management and outcome. VATS was performed after placing a paraxyphoid endoscopic portal and 2-3 intercostal instrument portals. VATS exploration was followed by one or more of the following: mediastinal debridement, tissue sampling, pleural lavage, and placement of a thoracostomy tube. Two dogs (14%) required conversion from VATS to an open thoracotomy to completely resect proliferative mediastinal tissue. These dogs had severe pleural effusion on preoperative thoracic radiographs and one had severely thickened contrast-enhancing mediastinum on preoperative computed tomography (CT). The cause of pyothorax was identified as a penetrating gastric foreign body (n = 2), migrating plant material (n = 2), and idiopathic (n = 10). The median follow-up time was 143 days (range, 14-2402 days). All dogs were discharged from the hospital and their clinical signs resolved. One patient had recurrence of a pyothorax requiring revision surgery 17 months postoperatively. VATS allows minimally invasive treatment of uncomplicated canine pyothorax. Preoperative thoracic CT may help identify candidates for VATS among dogs with pyothorax.

Gastric foreign body: a comb

Key Clinical MessageThe ingestion of a foreign body is a common occurrence. Psychiatric patients and prisoners may swallow objects on purpose. Occasionally emergent exploratory laparotomy may be indicated if the diagnosis is uncertain, and emergent removal of the foreign body may be needed to prevent substantial risk of serious complications including perforation, fistula, or gastrointestinal bleeding.

Acute Zinc Toxicosis in a Dog with a Gastric Foreign Body

Acute Zinc Toxicosis in a Dog with a Gastric Foreign Body

A Case Report

Rapunzel syndrome is very rare gastric foreign bodies that occur in children. It is a severe condition of a gastric trichobezoar with a long tail that passes into the small intestine. Here, we present the case of an 8-year-old girl with Rapunzel syndrome due to a very large (7 × 7 × 30 cm) gastric trichobezoar. The patient had trichotillomania and trichophagia for 1 year prior to presentation. Ideally, small bezoars are removed through a minimally invasive method, such as endoscopic fragmentation. However, large trichobezoars, including those in Rapunzel syndrome, can only be managed with open surgical extraction, despite the large scars that may result.We report a case of Rapunzel syndrome with a large bezoar that was surgically removed after it was endoscopically cauterized with argon plasma. Endoscopic precutting was used to effectively reduce the size of the bezoar.

Ingestão de chumbo de pesca em cão – relato de caso

Gastric foreign bodies are found in dogs and cats of all breeds and ages. However, according to the literature and to routine clinics and hospitals, young animals ingest foreign bodies more commonly than adults. In addition to vomiting, anorexia, depression and abdominal pain may also be present. Radiography is a complementary test method that is most often helpful in diagnosing the presence of these objects. A gastrostomy is indicated when removal of the foreign body cannot be achieved. Lead is a toxic metal that is extremely harmful when absorbed by the body. This work reports the case of a mongrel bitch that ingested large amount of lead parts used as weight in angling. The patient underwent surgery for removal of the foreign material, and failed to show symptoms of heavy metal poisoning.

The Role of Endoscopy in the Diagnosis of Digestive Pathology

Nowadays, endoscopy represents one of the most useful tools in the diagnosis of digestive pathologies in human beings and animals. Whether we are talking about upper or lower gastrointestinal tract endoscopies, these procedures dramatically increase the capacity to diagnose digestive disorders in dogs and cats. The aim of the present study is to investigate the role of endoscopy in the diagnosis of digestive pathologies.This paper represents our 5 years’ experience in digestive endoscopy. During this period we performed more than 150 digestive procedures in dogs and we diagnosed a heteromorphic digestive pathology. Clinical cases were represented by client-owned dogs that were referred to our clinic with a suspicion of digestive pathology.. We diagnosed erosive esophagitis and esophageal foreign bodies, hemorrhagic gastritis and ulcers, gastric and intestinal tumors, infiltrative enteritis, cecal intussusception, and colorectal carcinoma. It must be stressed that these diagnoses were missed using other investigative methods, and we can sustain that endoscopy dramatically increases our diagnostic capacity. Moreover in some conditions (for e.g. esophageal or gastric foreign bodies) endoscopy could also be used as a therapeutic tool.We recommend endoscopy in every case where there is a suspicion of digestive pathology and where other diagnostic tools did not reveal any abnormalities. The main disadvantages of endoscopy were the need for anesthesia in case of upper G.I. series and the cost of the procedure. We did not encounter any complications related to anesthesia or the procedure itself.

Multiple Foreign Bodies in the Stomach

Foreign body ingestion is common and is a frequent gastrointestinal emergency. The majority of ingested foreign bodies pass spontaneously. We are reporting an unusual patient who ingested multiple spoons, which caused abdominal pain and required endoscopic and surgical interventions for retrieval. A 34-year-old male inmate with a history of schizophrenia presented to the ED complaining of acute abdominal pain. He denied nausea, vomiting or constipation, he takes his medications regularly. His physical examination revealed normal vital signs. His abdominal examination showed moderate tenderness, mainly in the right upper quadrant, but no rebound tenderness, and normal bowel sounds. Laboratory data were within normal limits. A plain abdominal x-ray film showed several radiopaque foreign bodies in the stomach with a nonspecific ileus. CT of the abdomen showed multiple spoons in stomach and duodenum. Endoscopy done showed about six plastic spoons in the stomach, but retrieval failed due to the size of the grasping forceps used for evaluation. Endoscopy with a larger retrieval device was repeated on the second day, and approximately fourteen plastic spoons were found in the stomach. Six spoons were removed with a rat-toothed forceps. Endoscopy was repeated a second time, and seven spoons were found in the stomach along with two plastic spoons embedded in the wall of the duodenum with ulceration. The seven spoons in the stomach were removed by using a raptor forceps. The patient underwent exploratory laparotomy with gastrostomy, and two spoons were removed from the duodenum. Postoperatively, patient did well, his abdominal pain improved.Figure 1Figure 2FB ingestion is a commonly occurs in children and it is usually accidentally but can result from deliberate ingestion. Patients with mental illness and prisoners are prone to problems caused by purposeful ingestion of foreign bodies. 90% of ingested foreign bodies pass through the gastrointestinal tract without complications, 10% to 20% require endoscopic removal, and 1% will need a surgical intervention. Complications include hemorrhage, bowel obstruction, perforation, and erosion into adjacent viscera. Endoscopy indicated for gastric or proximal duodenal foreign bodies that have a diameter of more than 2 cm, a length of more than 5 cm, an eccentric shape, or are prone to enlodgement/perforation, such as open safety pins or swallowing of batteries. Swallowing of long spoons is a rare event.

Point-of-care Ultrasound: A New Tool for the Identification of Gastric Foreign Bodies in Children?

BackgroundPoint-of-care ultrasound (POCUS) has been used to identify ingested gastric foreign bodies. Our aim was to describe the sonographic findings of radiopaque and radiolucent gastric foreign bodies (FBs) in children. Case ReportThree children ingested different FBs. Two were confirmed with standard radiographs, one was not identified radiographically but was passed in the stool. All three objects were initially found in the stomach using POCUS. Why Should An Emergency Physician Be Aware of This?With increased training and comfort, emergency physicians may begin to use POCUS for identification and monitoring of ingested FBs in the pediatric population.

A comparative study of two-dimensional and three-dimensional ultrasonography in evaluation of gastric affections in dogs.

Aim:The objective of the study was to obtain and compare the two-dimensional (2D) and three-dimensional (3D) ultrasonographic images of pathological conditions of the stomach in dogs in clinical cases.Materials and Methods:In our study, 12 clinical conditions of the stomach were recorded using ultrasonography. The ultrasound machine used for this study was 3D ultrasound machine (Nemio-XG: Toshiba, Japan) having four-dimensional volumetric transducer.Results:Present study was done to compare 2D and 3D ultrasonographic images in different gastric affections in dogs. In case of uremic gastropathy due to inflammatory response, the wall of the stomach was 0.6 cm thick and hyperechoic and gastric folds were also hyperechoic indicative of gastritis. In second, third, and fourth case of gastritis the wall of the stomach was 0.7, 0.6, and 0.55 cm, respectively thick and hyperechoic. In fifth and sixth case of gastritis, inflammatory response due to ingestion of polythene and sand led to gastritis and ultrasonographically, the wall of the stomach was 0.6 cm and 0.7 cm thick, respectively, and hyperechoic. In case of gastric ulcer, ultrasonographically, there was a disruption of gastric mucosal layer. In cases of gastric dilatation, anechoic content indicating fluid was seen in stomach area and due to dilatation boundary of the stomach was not clear and the increase in the lumen of the stomach was observed. In case of foreign body, ultrasonographically the wall of the stomach was 0.55 cm thick and hyperechoic. In the middle of the stomach, multiple hyperechoic shadows of the foreign bodies i.e. leather and bunch of straw of grass were observed. In case of pyloric stenosis ultrasonographically, anechoic lumen of the pylorus surrounded by 0.5 cm hypoechoic thickened muscle. In some cases, 3D ultrasonography was not diagnostic i.e. gastric foreign bodies and gastric dilatation. These conditions were better visualized on the 2D sonogram.Conclusion:The appearance of clinical conditions of the stomach such as gastritis and pyloric stenosis were more distinct on 3D ultrasonogram than 2D ultrasonogram. The 3D ultrasonography was not diagnostic in cases of gastric foreign bodies and gastric dilatation.

Suspect anaphylaxis following intravenous buprenorphine administration in a dog

A seven-month-old French Mastiff was scheduled to undergo exploratory laparotomy for the removal of gastric foreign bodies. Buprenorphine 20 μg/kg was administered intravenously as preanaesthetic medication. Five minutes after the...

Surgical Management of Gastric Foreign Body in a Dog

Surgical Management of Gastric Foreign Body in a Dog

Validation of a realistic simulator for veterinary gastrointestinal endoscopy training.

This article reports on the face, content, and construct validity of a new realistic composite simulator (Simuldog) used to provide training in canine gastrointestinal flexible endoscopy. The basic endoscopic procedures performed on the simulator were esophagogastroduodenoscopy (EGD), gastric biopsy (GB), and gastric foreign body removal (FBR). Construct validity was assessed by comparing the performance of novices (final-year veterinary students and recent graduates without endoscopic experience, n=30) versus experienced subjects (doctors in veterinary medicine who had performed more than 50 clinical upper gastrointestinal endoscopic procedures as a surgeon, n=15). Tasks were scored based on completion time, and specific rating scales were developed to assess performance. Internal consistency and inter-rater agreement were assessed. Face and content validity were determined using a 5-point Likert-type scale questionnaire. The novices needed considerably more time than the experts to perform EGD, GB, and FBR, and their performance scores were significantly lower (p<.010). Inter-rater agreement and the internal validity of the rating scales were good. Face validity was excellent, and both groups agreed that the endoscopy scenarios were very realistic. The experts highly valued the usefulness of Simuldog for veterinary training and as a tool for assessing endoscopic skills. Simuldog is the first validated model specifically developed to be used as a training tool for endoscopy techniques in small animals.

Development of Pneumoperitoneum after Endoscopic Retrieval of Gastric Foreign Body in a Dog

Development of Pneumoperitoneum after Endoscopic Retrieval of Gastric Foreign Body in a Dog

Unusual congenital pulmonary anomaly with presumed left lung hypoplasia in a young dog

A seven-month-old, entire, male miniature schnauzer dog was referred with acute vomiting, inappetence and depression primarily as a result of a gastric foreign body (pine cones). During investigations, thoracic radiographs revealed increased volume of the right lung lobes, deviated cardiomediastinal structures and elevation of the heart from the sternum. Thoracic computed tomography revealed left cranial lung lobe hypoplasia and extension of the right cranial lung parenchyma across the midline to the left hemithorax. Branches of the right pulmonary vessels and bronchi also crossed the midline and extended to the left caudal lung lobe. These findings suggested that the right and left lungs were fused. In humans this finding is consistent with horseshoe lung, which is an uncommon congenital malformation. To the authors' knowledge, this case represents the first report of such a pulmonary anomaly in a dog.

Gastric foreign body granuloma caused by an embedded fishbone: A case report

Fishbones are the most commonly ingested foreign bodies that cause gastrointestinal tract penetration. However, fishbones embedded in the gastrointestinal tract that lead to foreign body granulomas that mimic submucosal tumors are rare. Herein, we describe a 56-year-old woman who presented with a 20-day-history of upper abdominal pain. Endoscopy revealed an elevated lesion in the gastric antrum. An abdominal computed tomography scan showed a mass in the gastric antrum and a linear calcified lesion in the mass. An endoscopic ultrasonography examination revealed a 3.9 cm × 2.2 cm, irregular, hypoechoic mass with indistinct margins in the muscularis propria layer. The patient was initially diagnosed as having a submucosal tumor, and subsequent surgical resection showed that the lesion was a foreign body granuloma caused by an embedded fishbone. Our case indicated that the differential diagnosis of a foreign body granuloma should be considered in cases of elevated lesions in the gastrointestinal tract.

Successful treatment of liver abscess secondary to foreign body penetration of the alimentary tract: A case report and literature review

Hepatic abscess caused by foreign body penetration of the alimentary tract is rare. We report a case of gastric antrum penetration due to a toothpick complicated by liver abscess formation. A 41-year-old man was admitted to our hospital with the chief complaint of upper abdominal pain for 2 mo. Esophagogastroduodenoscopy performed at a local clinic revealed a toothpick penetrating the gastric antrum. Computed tomography (CT) of the abdomen at our hospital revealed a gastric foreign body embedded in the posterior wall of gastric antrum with regional phlegmon over the lesser sac and adhesion to the pancreatic body without notable vascular injury, and a hepatic abscess seven cm in diameter over the left liver lobe. Endoscopic removal of the foreign body was successfully performed without complication. The liver abscess was treated with parenteral antibiotics without drainage. The patient's recovery was uneventful. Abdominal ultrasonography demonstrated complete resolution of the hepatic abscess six months after discharge. Relevant literature from the PubMed database was reviewed and the clinical presentations, diagnostic modalities, treatment strategies and outcomes of 88 reported cases were analyzed. The results showed that only 6 patients received conservative treatment with parenteral antibiotics, while the majority underwent either image-guided abscess drainage or laparotomy. Patients receiving abscess drainage via laparotomy had a significantly shorter length of hospitalization compared with those undergoing image-guided drainage. There was no significant difference in age between those who survived and those who died, however, the latter presented to hospitals in a more critical condition than the former. The overall mortality rate was 7.95%.