Gastrointestinal Foreign Bodies Research Articles

Gastrointestinal system foreign bodies

Gastrointestinal system foreign bodies

Management of Gastrointestinal Foreign Bodies with Brief Review of the Guidelines

Foreign body (FB) ingestion is a common health problem that affects children more than adults. According to gastroenterologists' guidelines, the management of FB ingestion differs slightly between adult and children. This review aimed to compile adult and children guidelines and establish an understandable association to reveal the requirements and timing of the endoscopic procedure, which is the most effective and least complicated technique for gastrointestinal FBs. Coins, pins, and chicken and fish bones have been the most commonly ingested FBs. However, with their increasing use in recent years, large batteries with lithium-ion conversion, stronger magnets composed of rare earth metals, such as neodymium, and superabsorbent objects have become the most morbid and mortal, necessitating new management strategies. Although the approach to gastrointestinal FBs is controversial, with different treatment options available in different disciplines, many studies have demonstrated the efficacy and safety of endoscopic procedures. Many factors influence the timing of endoscopy, including the nature, size, and location of the ingested object and the patient's clinical condition.

Successful Surgical Removal of a Perforating Ventricular Foreign Body from a Mallard Duck (Anas platyrhynchos): A Case Report

Swallowing foreign bodies is an important cause of emergency visits in pet birds. An adult female mallard duck with a history of anorexia, weakness, and depression was referred to the Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran. Radiographic examination showed the penetration of a needle in the ventriculus (gizzard). Since foreign bodies can lead to obstruction and injury that is life-threatening, the team's decision was surgical removal by ventriculotomy under general anesthesia. The patient was laid in dorsal recumbency on a heating pad, and the feathers around the incision site were removed. Then a skin incision was made in the middle of the abdomen. The ventriculus was explored, and the infiltrated foreign object was carefully removed. To the best of the authors’ knowledge, this study reports the first successful foreign body removal surgery in a duck in Iran. During the 10-day follow-up period, no complications were observed, and the duck was healthy. Prompt intervention and surgical treatment might be necessary to remove penetrating gastrointestinal foreign bodies located in the gizzard of domestic ducks.

Causes of mortality of kiwi (Apteryx spp.) in New Zealand: a retrospective analysis of post-mortem records, 2010–2020

ABSTRACT Aims To examine and assess causes of mortality of kiwi (Apteryx spp.) submitted to Massey University between 2010 and 2020 across the five recognised species according to location, age group and captivity status in New Zealand. Methods Post-mortem reports were obtained from the Massey University/Te Kunenga ki Pūrehuroa School of Veterinary Science/Wildbase Pathology Register. Inclusion criteria were all species of kiwi with a date of post-mortem examination between August 2010 and August 2020. Data from each report was exported, categorised and compared using Microsoft Excel. Results Of a total of 1,005 post-mortem reports, there were 766 North Island brown kiwi (NIBK; A. mantelli), 83 tokoeka (A. australis), 73 rowi (A. rowi), 49 great spotted kiwi (A. haastii), and 34 little spotted kiwi (A. owenii). This comprised 19 eggs/embryos, 125 neonatal, 473 juvenile, 153 subadult, and 235 adult kiwi. There were 615 kiwi from wild populations, 148 from sanctuary populations, 238 from captivity, and four from unspecified locations. The leading cause of death was trauma, affecting 322 (32.0 (95% CI = 29.2–35.0)%) kiwi including 289 (37.3 (95% CI = 26.0–31.7)%) NIBK. Nearly half of these died from predation by mustelids, with losses recorded from neonates to adults and clustered in the central to southern North Island. Predation by dogs was the second most common cause of death, killing 84 (8.4 (95% CI = 6.7–10.2)%) kiwi, of which 65.5% came from the northern districts of the North Island. Non-infectious disease killed 214 (21 (95% CI = 18.8–24.0)%) kiwi, and included developmental deformities, gastrointestinal foreign bodies and predator trap injuries. Infectious disease killed 181 (18.0 (95% CI = 15.7–20.5)%) kiwi and the proportion decreased with age, with common diagnoses including coccidiosis, bacterial septicaemia, avian malaria, and fungal respiratory disease. Starvation affected 42 (4.2 (95% CI = 3.0–5.6)%) kiwi, comprised of mainly neonatal or juvenile individuals from wild or sanctuary populations, with a higher percentage seen in tokoeka (11/83; 13.3%) compared to other species (min 0%, max 5.9%). The cause of death was undetermined in 246 (24.5 (95% CI = 21.8–27.3)%) cases, which was most often due to poor preservation of remains. This included 33/73 (46%) rowi and 32/83 (39%) tokoeka, and affected mainly birds from sanctuary and wild populations. Conclusions This study enhances our understanding of causes of mortality in captive, wild and sanctuary populations of all kiwi species and age groups within contemporary New Zealand.

Diagnosis, treatment and outcome of metallic foreign body ingestion in two new world camelids

AbstractA 14‐year‐old alpaca and a 3‐year‐old llama presented independently with vague symptoms of abdominal discomfort. Bloodwork was unremarkable in the alpaca, but showed signs of sepsis in the llama, and abdominal ultrasonography was normal in both animals. Abdominal radiography revealed a metallic gastrointestinal foreign body in both cases. Ventral midline laparotomy was performed, and the foreign bodies were retrieved from the C3 compartment in the alpaca and from the proximal duodenum in the llama. Both camelids received broad‐spectrum antimicrobial drugs, non‐steroidal anti‐inflammatory drugs and supportive care. The alpaca and llama were discharged from the hospital 16 and 8 days after surgery, respectively. The alpaca was euthansed due to recumbency of unknown aetiology 2 months later, while the llama was doing well 4 months after discharge. This report shows the usefulness of abdominal radiographs in camelids presenting with unspecific clinical signs and demonstrates that hardware disease should be considered as a differential diagnosis.

AN UNFORTUNATE VISIT TO THE DENTIST

AN UNFORTUNATE VISIT TO THE DENTIST

Gastrointestinal linear foreign bodies in cats: A retrospective study of 12 cases

Gastrointestinal foreign bodies are common in animals and may present with various clinical manifestations depending on the location, severity, and duration of the obstruction. Linear foreign body (LFB) obstructions are more common in cats compared to dogs, and the foreign body causing the obstruction is usually thread or threaded needle. In our study, it was aimed to determine the radiography and the localization of the obstruction in the diagnosis of LFB in cats, to investigate the operative treatment options and their effects on the prognosis. The study material consisted of 12 cats of different breeds, ages, and genders, who were referred with the suspicion of foreign body with acute/chronic vomiting and anorexia. After the identification of the foreign body causing the obstruction, treatment was planned considering its localization, severity and duration of pathology. All foreign bodies were removed surgical procedures. The most common finding was the plication in the intestines. Four cats died in the postoperative period. As a result, early and rapid diagnosis in LFB positively affects the prognosis. Intestinal perforations caused by LFB and infection due to bacterial translocation are inevitable in delayed cases. Another issue to be considered is that in cats that show symptoms of gastrointestinal system origin, it is extremely important to carry out a detailed examination of the mouth. In addition, it is thought that trying to pull out the LFBs that protruding out from the anus increases the risk of perforation in the intestines.

Erratum for "Gastrointestinal foreign bodies in pet pigs: 17 cases".

Erratum for "Gastrointestinal foreign bodies in pet pigs: 17 cases".

Clinical Research Progress of Foreign Bodies in Digestive Tract

Foreign body of digestive tract refers to the noninherent substances retained in the digestive tract caused by various reasons. Foreign body incarceration is one of the clinical emergencies, occurs at all ages, whose incidence is second only to gastrointestinal bleeding, accounting for about 4% of emergency endoscopic diagnosis and treatment. If not treated timely, foreign body incarceration may cause gastrointestinal erosion, ulcer, bleeding, perforation, obstruction and aortic rupture which is life-threatening. According to the characteristics of patients, dietetical characteristic, types of gastrointestinal foreign bodies, retention time of foreign bodies, incarcerated sites, clinical manifestations, complications, treatment methods, average length of stay and expenses, we explore the research progress of gastrointestinal foreign bodies to improve the level of diagnosis and treatment, as well as increase the cure rate and reduce complications. This review aims to summarize the clinical diagnosis and treatment methods of gastrointestinal foreign bodies for clinicians and strengthen readers' understanding of gastrointestinal foreign bodies.

Endoscopic and Surgical Removal of Gastrointestinal Foreign Bodies in Dogs: An Analysis of 72 Cases.

Simple SummaryThe ingestion of foreign bodies is common in dogs. The aim of this multicentre retrospective study was to evaluate the most common location and type of gastrointestinal foreign bodies in dogs. Animal signalment, clinical factors and outcomes of dogs undergoing surgical or endoscopic treatment for foreign body removal were also examined. A high rate of affected dogs was young, male, and of a large breed. The main foreign body location was the stomach; endoscopic removal was associated with a high rate of success in gastric foreign bodies, whereas enterectomy and multiple surgical incisions were linked to a poor outcome.In emergency veterinary practice, gastrointestinal foreign body (GFB) removal is a common procedure that is performed with different techniques, such as endoscopy or surgery. The aims of this retrospective, multicentre, clinical study were to report the common locations and types of objects recovered and to investigate clinical factors and outcomes in dogs after surgical or endoscopic treatment for GFB removal. Records of dogs with a GFB diagnosis referred to the Teaching Veterinary Hospital or treated in three different veterinary hospitals from September 2017 to September 2019 were examined. The data obtained from each case included breed, age, clinical signs at presentation, duration of clinical signs, type and location of the GFB, treatment, length of hospitalisation and outcome. Seventy-two dogs were enrolled in the study. There were 42 males (58%) and 30 females (42%). The median age was 36 months (range: 3 months to 8 years). Endoscopic retrieval was performed in 56% of GFBs (located in the stomach or duodenum), whereas 44% of dogs underwent surgery. The type of FB detected varied greatly: kid toy (14%), metallic object/coin (13%), cloth (13%), sock (8%), ball (8%), plastic material (8%), peach stone (7%), fishhook (6%), sewing needle (4%), hair tie (4%), pacifier (3%), plant materials (3%) and others (9%). Moreover, the FBs were classified as sharp (13%, n = 9), pointed (33%, n = 24), blunt (26%, n = 19), or linear (28%, n = 20). In this study, 68% of FBs were localised in the stomach, 25% in the intestinal tract (50% duodenum, 28% jejunum, and 22% ileum), and 7% in both the stomach and small intestine. The type of GFB was not significantly associated with age, site or breed. There was a significant association between the type of GFB and sex: if the dog was male, there was a 38% probability of ingesting linear GFBs. The dog survival rate was 100% in cases treated by gastric endoscopic or surgical removal, 94% in cases treated with enterotomy and 33% in cases in which enterectomy was necessary. Enterectomy and multiple surgical sites were associated with a poor outcome. The presence of vomiting for more than 24 h was significantly associated with death.

Gastrointestinal foreign bodies in pet pigs: 17 cases.

BackgroundPigs have an indiscriminate eating behavior placing them at high risk of developing foreign body (FB) obstructions.ObjectivesDescribe the clinical and diagnostic features, treatments, and outcome of pet pigs diagnosed with gastrointestinal (GI) FBs. Medical and surgical treatments, pig outcomes, and post‐mortem findings were also investigated.AnimalsSeventeen pet pigs.MethodsA multicenter retrospective study was conducted. Gastrointestinal FBs were defined as swallowed objects that became lodged within the gastrointestinal tract distal to the cardia identified during exploratory laparotomy.ResultsCommon clinical signs were anorexia/hyporexia, tachypnea, vomiting, dehydration, tachycardia, and ileus. Diagnostic imaging identified the presence of a FB in 4 cases. Upon celiotomy, the FBs were in the stomach and small intestine in 17 cases and large colon in 2 cases. Types of FB included fruit pit, diaper, and metallic objects. Of the 17 pigs, 15 (88%) were discharged from the hospital and 2 (12%) were euthanized.Conclusion and Clinical ImportanceClinical signs of GI FB were similar to those reported in obstipated pigs. Diagnostic imaging has limitations for detection of FB. Surgical removal of FBs in pigs carried a good prognosis.

FOREIGN BODIES OF THE UPPER DEPARTMENTS OF THE GASTROINTESTINAL TRACT

In recent years, the number of patients with foreign bodies in the gastrointestinal tract who need hospital treatment has increased significantly. However, in some cases there are complications that lead to death or require complex reconstructive surgery.
 Objective: to improve the results of treatment of patients with gastrointestinal foreign bodies by improving treatment tactics.
 Materials and methods: the object of the study were 223 patients who sought help in the “Regional Clinical Hospital” Kharkiv in the period from 2016 to 2021. Particular attention was paid to aggressive foreign bodies (alkaline batteries, wedged in the esophagus). projects and more).
 Results: foreign bodies were removed in the shortest possible time by esophagogastroduodenoscopy.
 Conclusions:
 1. Dynamic monitoring of a swallowed foreign body without its endoscopic removal is recommended when patients have no clinical symptoms and the foreign body is blunt, inert and small, is there is a guarantee of its safe involuntary discharge.
 
 Flexible endoscopy — the best diagnostic and therapeutic method for foreign bodies in the upper gastrointestinal tract, with a success rate of 95%
 Emergency, within 2 hours of admission, endoscopic intervention is recommended for foreign bodies that have caused complete obstruction of the esophagus, as well as for acute foreign bodies and batteries located in the esophagus.

Cuerpos extraños gastrointestinales en perros y gatos: (2018-2020) 32 casos

Gastrointestinal foreign bodies (GFB) in cats and dogs are among the life-threatening surgical diseases that require invasive surgery. This study aimed to evaluate the cases of GFB in 32 cats and dogs diagnosed and treated in Hatay Mustafa Kemal University Veterinary Health Practice and Research Hospital. Information regarding the type, breed, age, sex, clinical symptoms, characteristics of foreign bodies (FB), localization, prognosis, type of treatment administered, and conditions determined in postoperative controls was collected. The cases were aged between 1 and 7 years and adult animals were also included. The rate of FB incident was the same in male and female cats, whereas male dogs had a higher rate of FB incident. Strings/ropes and metallic objects were the most common foreign objects found in animals. Early diagnosis and treatment were important in preventing complications in the cases, FB was usually found in the stomach, and vomiting was the most common clinical symptom. Further, surgical intervention (gastrostomy/enterotomy) was the most common treatment method with a rate of 53.13 % for treating FB in the gastrointestinal system that yielded successful results. Thus, to avoid complications and for a good prognosis, owners must be conscious and seek for diagnosis and treatment as soon as they notice the incidence of swallowing a FB, so as to ensure early diagnosis and treatment.

Multiple gastrointestinal magnetic foreign bodies in children

Objective: To introduce the analysis of the clinical picture, treatment strategy and complications among children having multiple foreign magnetic bodies (FB).Methods: Retrospective analysis of the treatment of 796 children from 2013 to September 2021 having stomach and intestine FB. Comprehensive study included plan radiography of the abdomen, fiberoptic gastroduodenoscopy, etc.Results: Magnets were detected in 33 (4.15%) out of 796 cases. 9 patients swallowed multiple foreign magnetic bodies (FB) within time interval. The parts fixed in different parts of gastrointestinal tract (GIT) and required surgical removal. All patients had multiple perforations of different GIT parts. It required suturing gut wall, bowel resection applying gastrointestinal anasto mosis and celiogrhaphy, resection applying anastomosis and by leaving the programmed laparostomy. Every patient recovered. Algorithm of supervision of children having FB GIT.Conclusions: Multiple foreign magnetic bodies of GIT among children in the current moment are the most dangerous foreign objects accompanied with big amount of complications. They are observed among children of any age and gender and require complicated and long surgical interventions. Multiple foreign magnetic bodies of GIT can be suspected in case of severe surgical pathology along with the lack of passage of radiopaque FB in GIT. Urgent surgical intervention is required in case of detecting it.

Successful retrieval of gastrointestinal foreign bodies in a street dog

Successful retrieval of gastrointestinal foreign bodies in a street dog

Endoscopic foreign body retrieval from the caecum - A case report and push for intervention guidelines.

Introduction and importanceEndoscopic foreign body retrieval in the upper gastrointestinal tract is well established, however indications for endoscopy for retained foreign bodies in the lower gastrointestinal tract and specifically the right colon is still being navigated [3]. A PubMed and Google Scholar search discovered a variety of case reports detailing various methods and indications for endoscopic retrieval of right sided colonic foreign bodies. This case report endeavors to supplement the literature so that guidelines can one day be established for colonoscopic retrieval of right-sided foreign bodies.Case presentation36-year-old male prisoner swallowed 6.5 cm nail clippers with a long-standing history of intentional foreign body ingestion (FBI) including multiple laparotomies for foreign body retrievals. Computerized tomography (CT) was used initially to confirm the position of the nail clippers. After almost two weeks of failure of the foreign body (FB) to move beyond the caecum as demonstrated on plain abdominal X-rays, the patient had a colonoscopy with successful retrieval of the FB.Clinical discussionThis case report hopes to encourage the consideration of colonoscopy for retrieval of right sided colonic foreign bodies that have failed to pass on their own and where an operation may come with increased risk (multiple laparotomies, multiple comorbidities, and higher anaesthetic risk for a general anaesthetic). Colonoscopy/endoscopy still has inherent risk and this patient did have an episode of temporary laryngospasm that required intubation and monitoring in the intensive care unit post operatively. Despite this the patient recovered and was discharged day one post procedure without further complication. The case report has been reported in line with the SCARE 2020 criteria (Agha et al., 2020 [2]).ConclusionIndications for consideration of endoscopic retrieval of foreign bodies in the right colon have not been entirely detailed as endoscopy is for upper gastrointestinal foreign bodies. This case report documents the indications for endoscopy in the clinical context of a recurrent FBI and a history of multiple laparotomies with failure of the FB to move beyond the caecum.

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.

Overview on Gastrointestinal Foreign Bodies in Children

Introduction: Greatest percentage of the upper gastro intestinal accidently swallowed foreign bodies in adults are related to food bolus impaction with meat. Most patients who swallow a true foreign body typically are younger, however young children were recorded to accidently swallow other objects rather than food poluses. Males are more often recorded, and often have significant psychiatric illness and/or drug abuse. Foreign body (FB) ingestion is a very common problem in children. FB may pass through gastrointestinal (GI) system silently without any indication, or it may need an intervention to prevent complications. The diagnosis, decision for involvement and management may have some difficulties, and it’s usually decided according to the case, especially in cases with protracted lodgment. Complications caused by lodgment of ingested GI FBs varies according to many factors and are associated with important morbidity and mortality in children.
 Objectives: to show an overview of gastrointestinal foreign bodies in children, its epidemiology, risk factors, hazards and management.

Upper gastrointestinal foreign bodies in adults: A systematic review

Foreign body(FB) ingestion in the upper digestive tract is a common emergency that lacks sufficient attention in adult population. Improper management may bring additional injuries and financial burdens to patients. This review was performed to determine the clinical characteristics of upper gastrointestinal FBs, including the demographic of adult patients, the type and location of FBs, underlying diseases of patients and other risk factors, and outcomes. We searched PubMed, MEDLINE, EMBASE and Cochrane databases with the terms "foreign body AND upper gastrointestinal NOT child". Finally, we got 7 articles between 2001 and 2020 and extracted the information. A total of 1391 patients were included. 736 (52.9%) patients were males and 655 (47.1%) were females. Fish bone was the most common type of FBs. Esophagus accounts for the most location in the upper digestive tract. 18.2% (235/1291) patients had the underlying diseases, and 11.7% (58/494) had other risk factors. The overall complication rate was 4.5% (63/1391).

1582 Radiolucent Foreign Bodies Presenting As IBD- The Case of An Ingested Plastic Straw Disguising as Crohn’s Disease

Abstract Ingested foreign bodies (FBs) occur most commonly in children or adults with impaired neurological function. Overall, 80% are thought to pass spontaneously in the faeces, with around 20% requiring endoscopy and less than 1% requiring surgical intervention. ‘Missed’ gastro-intestinal FBs are rare and often due to the lack of an obtainable history in patients with communication difficulties. We present the unusual case of a 27-year-old female with severe learning difficulties and a complex surgical history who presented with a 2-year history of increasing abdominal discomfort due to a ‘missed’ FB. Four CT scans had misdiagnosed Crohn’s disease and the patient was due to commence immunosuppression when she developed a small bowel perforation. This was managed conservatively and follow-up imaging with a CT with oral contrast detected the FB in the ileum. The patient underwent a laparotomy with resection of a 26cm segment of ileum containing a plastic straw. Post-operatively she recovered uneventfully and is now symptom free with no evidence of IBD on histology. This case highlights the value of oral contrast enhancement imaging in patients who don’t fit a ‘classical’ inflammatory bowel disease presentation.