Gastrointestinal Foreign Bodies Research Articles

Foreign Body Ingestion in Children: An Experience of 99 Cases in a Tertiary Care Center in Delhi

ABSTRACT Background: Accidental ingestion of foreign bodies in children is critical, as the inability to effectively communicate can potentially lead to devastating consequences. We aimed to determine the epidemiology of foreign body ingestion and variability according to age, gender, type, and location of foreign body, and describe its management. Aim and Objective: The aim was to study the various types of foreign body ingestions in children admitted to pediatric surgery and their management. Materials and Methods: A retrospective study was conducted from January 2020 to June 2022 on children under the age of 12 years with a confirmed diagnosis of foreign body ingestion. Patients were clinically and radiologically assessed, after which standard protocols were followed wherein patients were followed by either observation or emergent management. Emergent management included removal of the foreign body by either endoscopy or surgery. Comparisons among multiple age groups, gender, type of foreign body, location of foreign body, and their management were analyzed. Results: Out of 99 subjects in our study, there were 76 boys and 23 girls. The median age of presentation was 5 years. Most children were asymptomatic at presentation. The most frequently ingested foreign body was a coin in all age groups. The majority of the foreign bodies were suspected to be in the small bowel. The foreign bodies that had crossed the duodenojejunal flexure (n = 74, 74.7%) were managed conservatively with the observation of a variable period of a minimum of 24 h and a maximum of 48 h. 21 cases were managed by endoscopic removal, while three cases required surgical intervention. Conclusions: Overall, the most common gastrointestinal foreign body was a coin in all age groups. Button battery is the most worrisome foreign body; however, depending on its position, it can be managed conservatively. Upper GI foreign bodies can be safely removed endoscopically. Parental counseling is very important for the prevention of ingestion of foreign bodies.

Radiographic identification of challenging gastrointestinal tract foreign bodies: a descriptive study of how appearance varies in air versus water to aid interpretation.

To provide veterinarians with updated radiographic descriptions of select radiolucent foreign material in a simulated gastrointestinal environment. 368 veterinarian respondents from the US. An online survey was administered between June 18, 2023, and July 2, 2023, through a private veterinarian-based social media group. Representative commonly ingested foreign bodies were radiographed surrounded by air and water to simulate being within the gastrointestinal tract. Two examiners evaluated and qualified the opacity of the objects for each environment. The private social media group had a total of 3,900 members including veterinarians from all disciplines. A total of 362 small animal veterinarians (9.3% of the group) responded to the study reporting a total of 123 foreign objects that were not causing mechanical obstruction at the time of initial presentation. Sixty-eight foreign bodies were reported greater than or equal to 5 times and grouped as balls (n = 4), food (9), fabric (14), wood (3), soft plastic (14), hard plastic (18), or other (6). Most (98.5% [67/68]) objects were easily identifiable in air. In water, 23.5% (16/68) of the objects were obscured, and 39.7% (27/68) had inversion of the major opacity when compared to the opacity in air. The opacity of some ingested radiolucent material can invert relative to air or fluid, which may reflect substantial differences in detection following repositioning. When known dietary indiscretion occurs, radiographing a sample of the material in air and water will improve the accuracy of assessment.

Detection of gastrointestinal foreign bodies in pets using single-grid-based dark-field X-ray imaging

Gastrointestinal foreign bodies (GI-FBs) occur when pets consume non-digestible items that do not readily pass through the stomach or intestines. While some GI-FBs pass through, many become lodged along the gastrointestinal tract and cause discomfort, often leading to sickness. Conventional absorption-based radiography is widely used to detect GI-FBs in pets. However, detecting low-density FBs, such as wood, plastic, clothing, and sticks, is typically difficult using conventional radiography. This study presents a novel approach for detecting low-density GI-FBs in pets by using single-grid-based dark-field X-ray imaging (SG-DFXI). It obtains microstructural information from small-angle X-ray scattering (SAXS) of the sample using a conventional X-ray source and grid. SG-DFXI requires minimal exposure and system setup and is specifically utilized to detect low-density materials that are invisible when using conventional radiography. To validate the efficacy of the proposed method, an experiment was conducted on a mouse phantom attached to a wooden chopstick as a low-density GI-FB. Quantitative evaluation was performed using image quality metrics of the contrast-to-noise ratio (CNR) and relative contrast gain (RCG). The CNR value measured in the dark-field image obtained with an autocorrelation length of ξG = 294 nm was 4.59, approximately 5.4 times larger than that of the absorption image obtained in the same imaging setup. In addition, the RCG characteristics improved as the autocorrelation length of the system increased; the RCG value for ξG = 294 nm was 5.4, approximately 3.2 times larger than that for ξG = 194 nm. Thus, increasing the autocorrelation length of the system is critical to improve its ability to detect low-density FBs. Consequently, SG-DFXI appears to be a promising method that can be used effectively and easily to detect GI-FBs in pets, which are barely visible in absorption images.

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

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.

Caso antemortem de insuficiência valvar atrioventricular em dragão barbudo (Pogona vitticeps) – relato de caso

An atrioventricular valve insufficiency is a common form of cardiac disorder in mammals, whereas it has rarely been reported in reptiles. A two-year-old male bearded dragon (Pogona vitticeps) was presented with acute onset of lethargy, inappetence and general weakness, increased respiratory effort, dark skin color, and arched back. A gastrointestinal foreign body was suspected, but radiography showed coelomic fluid accumulation. Ultrasound heart examination revealed turbulent blood flow at the level of the atrioventricular valves. Electrocardiography by modified Einthoven lead system (lead configuration 1) as described for Squamata, did not show significant changes. A tentative diagnosis of congestive heart failure as a result of valvulopathy was made. Treatment consisted of parenteral furosemide and fluid administration and assisted feeding with appropriate food intended for adult bearded dragons. The patient was weekly evaluated and successfully recovered over the four months. Echocardiography and electrocardiography were repeated 12 months later. The prescribed treatment was successful with complete resolution of clinical signs, and long-term surveillance of the bearded dragon (Pogona vitticeps).

Removal of foreign objects seen in the upper gastrointestinal tract with the help of endoscopy: A retrospective cohort study

Background/Aim: Delay in diagnosing and treating gastrointestinal (GI) tract foreign bodies may lead to serious complications. In this study, we aimed to retrospectively evaluate the patients who underwent emergency upper GI endoscopy for foreign body ingestion in our clinic. Methods: Between 2015 and 2022, we evaluated 68 patients who underwent emergency upper GI endoscopy with a prediagnosis of foreign body ingestion. The evaluation included factors such as age, gender, presenting complaints, foreign body type, localization, and treatment parameters. Results: Out of the 68 patients included in the study, 21 (30.89%) were female, and the mean age was 54.00 years. Among them, 43 (63.23%) presented with no active complaints, 23 (33.82%) with dysphagia and odynophagia, and two (2.94%) with vomiting. The swallowed objects were classified as follows: coin (n=2), pin (n=5), battery (n=11), drug plaque (n=6), esophageal foreign body (n=7), piece of meat (n=5), chicken bone (n=4), fish bone (n=5), razor (n=7), lighter (n=3), and toothpick (n=1). The foreign bodies were located in the esophagus in 23 cases (33.82%), in the stomach in 32 cases (47.05%), and in the duodenum in one case (1.47%). For 12 patients (17.64%), the foreign body could not be detected endoscopically but was detected using radiologic methods. Among the foreign bodies, 54 (79.41%) were successfully removed. In one patient (1.47%) who could not be removed endoscopically and another patient (1.47%) who developed gastrointestinal perforation due to a foreign body (toothpick), a surgical procedure was performed. Conclusion: Early diagnosis and treatment of foreign body ingestion are crucial in preventing serious complications. Endoscopy, a minimally invasive procedure, can be a safe alternative to surgical procedures, which may carry higher morbidity and mortality risks.

Delay of definitive care in cats and dogs with gastrointestinal foreign body obstruction following antiemetic administration: 537 cases (2012-2020).

To determine whether administration of antiemetic medication to dogs and cats with gastrointestinal foreign body obstruction (GIFBO) delays time to definitive care (surgery or endoscopy) and increases the risk of complications. Retrospective study (January 2012-July 2020). Private referral center. Five hundred and thirty-seven (440 dogs and 97 cats). None. Medical records of dogs and cats with GIFBO were reviewed for antiemetic administration at the onset of clinical signs, time from onset of clinical signs to first intervention and definitive care, GIFBO-related complications, and length of hospitalization. Antiemetics were prescribed for 200 of 537 patients (158 dogs, 42 cats). Antiemetic administration was associated with an increased time between the onset of clinical signs and definitive care (3.2days [95% confidence interval, CI, 2.8-3.5] vs. 1.6days [95% CI, 1.4-2.0]; P<0.001) but not with GIFBO-associated complications (P=0.45). Antiemetic administration was associated with an increased length of hospitalization (1.6days [95% CI, 1.4-1.7] vs. 1.1days [95% CI, 1.1-1.2]; P<0.001). A longer duration of clinical signs prior to intervention was associated with GIFBO-related complications (P<0.001) regardless of antiemetic administration. Antiemetic administration in patients with GIFBO was associated with increased time to definitive care and length of hospitalization but not GIFBO-associated complications. Antiemetics are not inherently contraindicated in patients for whom GIFBO is a differential, but clients should be counseled to monitor for progression of clinical signs and follow-up accordingly.

Postoperative injectable opioid use and incidence of surgical site complications after use of liposomal bupivacaine in canine gastrointestinal foreign body surgery.

To compare postoperative analgesic use and postoperative complications between dogs that received liposomal bupivacaine (LB) during surgical gastrointestinal foreign body (GIFB) removal and those that did not. Retrospective study. Two hundred five dogs. Medical records for all dogs with GIFB removal at the Purdue University Veterinary Hospital between May 2017 and August 2021 were searched. Incomplete records and dogs with less than 2 weeks' veterinary follow up were excluded. Data collected included: patient information, time until surgery, intraoperative findings, surgical data (including perforation at time of surgery, linear vs. solid, enterotomy vs. enterectomy), use of LB (including time and manner of administration), time to extubation after surgery, in-hospital postoperative analgesic use and duration, and postoperative complications. Fentanyl was noted as used/not used, quantified as mean hourly rate over 12 h intervals. All analyses were performed using commercial statistical software with p < .05 as the significance level. Dogs that received LB were heavier (n = 65, median 28.5 kg) than those that did not (n = 140, median 24.4 kg) (p = .005). Postoperative fentanyl use (p < .05 between 13 and 72 h) and hourly rates (p < .05 between 13 and 48 h) were less, and postoperative time in the intensive care unit (ICU) (p < .001) and hospital were shorter (p < .001) in dogs receiving LB. Postoperative wound complications were seen in 7/65 dogs (10.8%, 95% CI = 4.4-21.0%) with LB and 4/140 (2.9%, 95% CI = 0.8-7.2%) without LB (p = .039). Use of LB was associated with reduced postoperative analgesic use, and shortened ICU and hospital stay but also with wound complications. Caution should be used when using LB in (clean) contaminated surgeries.

Selected Research and Dramatic Surgery Fish Cases of Incisive Complete in Fish Surgical

Abstract&#x0D; Health problems which can be treated exclusively by surgical means are relatively uncommon in fish. Fish surgery feat is vital essential and inevitable for the at fish diseases treatment and fish recovery. Consequently, only a limited number of procedures have been developed and reported in the literature. Despite use of analogous surgical instruments and surgical techniques to those employed in other animals, fish are a very diverse taxon and specific anatomy and physiology should be reviewed before surgical procedures are performed. Surgical planning often requires advanced diagnostics such as ultrasonography and imaging. Essantial surgical procedures include cutaneous and intracoelomic mass excision, ophthalmic procedures, reproductive surgery, brain surgery, visceral organs surgery, gastrointestinal foreign body removal, visceral organs examples, and buoyancy concerns. This article reviews several surgical procedures that have been performed in fish and highlight various aspects of surgical care which relate specifically to fishes. In this review article, administration of sedation and anesthesia, anaesthetic agents, pain in fish, obtrusive fish cases surgery, fish cases surgery operations examples, frequently used anesthetics and preoperative considerations, underwater surgery, out of water surgery, specific surgery procedures, microsurgery techniques, laparoscopy, catheter implantation and laparotomy were discussed for fish researchers. Suggestions for appropriate postoperative management are also discussed.

Clinical predictors of surgical intervention for gastrointestinal magnetic foreign bodies in children

Background/aimsTo investigate the clinical situation, treatment methods, and clinical predictors of surgical intervention in children with magnetic foreign bodies in the digestive tract.Materials and methodsFrom January 2019 to June 2022, we retrospectively analyzed the clinical data of 72 children who ingested magnetic foreign bodies inadvertently in our hospital, including their general information, admissions, clinical manifestations, and treatment methods, as well as pertinent literature and statistical data. Following software processing, univariate and multivariate logistic regression analyses were conducted to determine the independent risk factors of this study.ResultsIn this study, 16 patients (22.2%) were discharged smoothly following conservative treatment and 19 patients (26.4%) were cured by gastroscopy. The remaining 37 patients (51.4%) were underwent surgery, in which 26 cases developed gastrointestinal perforation. There were statistical differences between surgery group and non- surgery group in the days of eating by mistake, clinical manifestations (nausea and vomiting, intermittent abdominal pain, abdominal muscle tension) and movement trajectory by every 24-h radiograph (P < 0.01). Logistic regression analysis showed that intermittent abdominal pain and abdominal muscle tension were independent risk factors for surgical treatment.ConclusionMagnetic foreign bodies seriously endanger children’s health. This study offers a single-center basis for the choice of surgical opportunity for intestinal obstruction or perforation caused by magnetic foreign bodies. Clinicians need immediate surgical intervention if the child shows symptoms of abdominal pain or abdominal tension.

Retrospective evaluation of surgical treatment of linear and discrete gastrointestinal foreign bodies in cats: 2009-2021.

Gastrointestinal foreign bodies (FBs) are an important cause of emergency surgical intervention in cats, but little information exists in the literature evaluating the risks and outcomes in this species. The study purpose was to describe cases of feline FBs and compare perioperative factors and outcomes between linear foreign body (LFB) and discrete foreign body (DFB) surgery in cats. The medical records from the University of Georgia Veterinary Teaching Hospital were searched for cats that had undergone surgery for FB removal between August 2009 and August 2021. Perioperative data were collected and described. Data were compared between cats with an LFB and cats with a DFB. A binomial probability series was used to estimate the likelihood of postoperative septic peritonitis or mortality in an additional cat in the series. A total of 56 cats were included in this study; 38 cats had a DFB and 18 had an LFB. No cats developed postoperative septic peritonitis, and all cats survived. The likelihood of postoperative septic peritonitis or mortality in an additional cat was estimated to be <5.2%. Cats with an LFB were found to have a significantly higher body condition score (P = 0.047), albumin (P = 0.025), American Society of Anesthesiologists status (P = 0.027), surgery length (P <0.001) and total cost of visit (P = 0.006) when compared with cats with a DFB. Cats with LFBs were more likely to develop a surgical site infection (SSI; P = 0.007) and be administered postoperative antibiotics (P = 0.017). Cats undergoing surgery for gastrointestinal FBs had a low incidence of postoperative complications. Cats with LFBs had longer surgeries and were more likely to develop postoperative SSIs.

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.

RISK FACTORS FOR GASTROINTESTINAL FOREIGN BODIES IN CATS: A RETROSPECTIVE STUDY IN EGYPT

Gastrointestinal foreign body (FB) obstruction in felines is one of the emergencies and commonly required surgical interventions. The purpose of this study was therefore to investigate the risk factors that could prone cats to ingest FB. This study was retrospectively conducted on sixty-five cats that had been diagnosed with FB obstruction. On the other hand, sixty-five cats that had no clinical findings suggestive of gastrointestinal illnesses were used as controls. Among cats with gastrointestinal illnesses, we found that 9.97% had FB obstructions. The most common presenting breeds of both cat patients with FB obstruction and controls were Persian and Siamese. Similarly, most of the presented normal and diseased cats were males. Cats with FB were younger (p&lt;0.05) than those of control cats. There was no significant difference in the body weight for cats with FB versus control cats. Among the investigated factors, we also observed that living style, anxiety/stress, and frequency of exercise were the only factors that were strongly associated with the occurrence of FB obstruction. In conclusion, observations of this study indicate that a living style, anxiety/stress, and frequency of exercise have a significant impact on cat behavior and should be seen by cat-owned clients as important to prevent pica. Thus, the likelihood of blockage of the gastrointestinal tract by foreign bodies can be reduced.

Management of duodeneal perforation due to toothpick ingestion

Ingestion of foreign body is one of the major cause of serious morbidity and mortality in gastrointestinal system . A 47-year-old male patient attended to the emergency department complaining of abdominal pain for about two days duration. On physical examination of the patient, tenderness was observed in right flank region. Computed tomography examination revealed a foreign body that had impacted the third part of the duodenum and perforated and extended to the retroperitoneal structures.. &#x0D; Afterwards, semi-elective laparotomy was decided and the foreign body was removed under bleeding control. The perforated area in the 3rd part of the duedonum was primarily repaired and omentopexy was performed. The patient was discharged on the 6th day without any problem in the postoperative follow-up. &#x0D; Gastrointestinal foreign body ingestion treatment approach should be determined according to the characteristic of the object, its proximity to the anatomical structures and the clinic..

Associations of abdominal discomfort and length of clinical signs with surgical procedure in 181 cases of canine small intestinal foreign body obstruction.

Gastrointestinal foreign bodies are a common indication for abdominal exploratory surgery. The objective of this study was to evaluate the relationship of pre-operative abdominal discomfort and duration of clinical signs with surgical resolution of canine small intestinal foreign body obstructions (SIFBO). We performed a retrospective study of 181 canine abdominal exploratory surgeries for confirmed SIFBO at two referral hospitals. Animals were categorized into five surgical groups (gastrotomy after manipulation into the stomach, enterotomy, resection-and-anastomosis [R&A], manipulated into colon, already in colon) and further grouped by whether entry into the gastrointestinal tract (GIT) was required. Abdominal discomfort was noted in 107/181 cases (59.1%), but no significant differences in abdominal discomfort rates were present among the surgical groups or between GIT entry and no entry groups. Clinical sign duration was associated with surgical procedure; median durations were R&A = 3 days (range, 1-9), enterotomy = 2 days (range, 1-14), gastrotomy = 2 days (range, 1-6), already in colon = 1.5 days (range, 1-2), and manipulated into colon = 1 day (range, 1-7). In a pairwise comparison, differences in the duration of clinical signs were found for obstructions manipulated into the colon versus R&A, gastrotomy versus R&A, and in colon versus R&A. When patients were grouped according to GIT entry, cases with entry had a longer duration of clinical signs (median = 2 days [range, 1-14] versus 1 day [range, 1-7], respectively). Abdominal discomfort was not associated with surgical complexity; however, the duration of clinical signs was associated with surgical complexity, with longer duration being associated with entry into the GIT and R&A. Despite statistical significance, the maximum difference of 2 days between surgical groups is unlikely to be clinically relevant.

Successful surgical management of gastro-intestinal linear foreign body in a 9 months old Indian male dog: A case report

Successful surgical management of gastro-intestinal linear foreign body in a 9 months old Indian male dog: A case report

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.