Upper GI foreign body: An adult urban emergency hospital experience

Conway, W. C., Sugawa, C., Ono, H. and Lucas, C. E. (2007). Upper GI foreign body: An adult urban emergency hospital experience. In: Annual Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons, Dallas, TX, United States, (455-460). 26-29 April 2006. doi:10.1007/s00464-006-9004-z

Author Conway, W. C.
Sugawa, C.
Ono, H.
Lucas, C. E.
Title of paper Upper GI foreign body: An adult urban emergency hospital experience
Conference name Annual Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons
Conference location Dallas, TX, United States
Conference dates 26-29 April 2006
Journal name Surgical Endoscopy   Check publisher's open access policy
Place of Publication Secaucus, NJ, United States
Publisher Springer New York LLC
Publication Year 2007
Sub-type Fully published paper
DOI 10.1007/s00464-006-9004-z
ISSN 0930-2794
Volume 21
Issue 3
Start page 455
End page 460
Total pages 5
Language eng
Formatted Abstract/Summary
Background: The efficacy of flexible endoscopy by a single endoscopist in the therapy of foreign body ingestion was assessed at an adult urban emergency hospital.
Methods: Fifty-one adult patients with upper GI foreign body ingestion treated at Detroit Receiving Hospital from 1988 to 2004 were identified. Endoscopic and hospital medical records were reviewed to evaluate etiology, treatment, and outcomes for these patients.
Results: The etiology was related to eating in 38(75%) patients, most of whom were eating meat; phytobezoars were seen in four, often after previous upper GI surgery. True foreign bodies were found in 13 patients (25%) and included a screwdriver, a ballpoint pen, spoons, coat hanger pieces, batteries, and latex gloves. Dysphagia was the most common symptom (75%); pain was common in patients with true foreign bodies, and 62% of this group had psychiatric difficulties or problems with drug abuse. Nearly 80% of the food-related group had post-surgical or other upper GI pathology. One patient had an esophageal stricture secondary to previous Sengstaken-Blakemore tube insertion. Flexible endoscopy was successful in extracting the foreign body in almost all (49) patients, with snare extraction the most common therapeutic modality. Both failures were of true foreign bodies that could not be safely removed. In one of these cases, it became necessary to employ the gallstone lithotripter, and the overtube was required in patients with metallic or sharp foreign bodies to protect the upper aerodigestive structures.
Conclusions: Most upper GI foreign bodies are related to food impaction, with meat most often found. Underlying pathology is the rule and should be dealt with immediately. Flexible endoscopy is the treatment of choice for upper GI foreign body removal with near perfect success.
Keyword Gastrointestinal foreign body
Endoscopic removal
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

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Created: Mon, 14 Mar 2011, 08:52:19 EST