Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion

The topic of foreign body ingestion has received extensive coverage in the areas of surgery, emergency medicine, and pediatrics. A subset of this topic, the intentional ingestion of foreign bodies, however, is much less common, and requires special evaluation and management. Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication. In many cases, ingestions of this type involve a command hallucination ordering the patient to swallow the foreign body. Interestingly, the patient in the present case reported auditory hallucinations commanding him not to swallow the can lid. On further investigation, we found that patient had a proclivity toward this swallowing behavior even prior to his incarceration. Early identification of inmates with this proclivity has important implications for treatment and prevention.

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Duodenal perforation nine months after accidental foreign body ingestion, a case report

BMC Surgery ◽

10.1186/s12893-019-0594-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Chi Li ◽

Chee-Chien Yong ◽

Domelle Dave Encarnacion

Keyword(s):

Case Report ◽

Gastrointestinal Tract ◽

Foreign Body ◽

Acute Abdomen ◽

Specific Treatment ◽

Foreign Body Ingestion ◽

Duodenal Perforation ◽

Tract Perforation ◽

Intentional Ingestion ◽

Plain Films

Abstract Background Foreign body ingestion is a scenario occasionally encountered in the emergency room. Pediatric and psychiatric patients are the two most common populations suffering from accidental or in some cases intentional ingestion of foreign bodies. Commonly, majority of cases require no specific treatment and the swallowed objects pass through the digestive tract spontaneously without causing any significant complications. Less than 1% of the cases complicates with gastrointestinal tract perforation, which are often caused by sharp objects, which warrants surgical intervention. The average time from foreign body ingestion to development of perforation was noted at 10.4 days in previous reports. These cases often present in rapidly progressing peritonitis and are subsequently managed by emergent laparotomy. In this case report, we describe an accidental chopstick ingestion of a patient who initially was misdiagnosed and remained asymptomatic for nine months, then presented with acute abdomen. Case presentation A 27-year-old man accidentally ingested a wooden chopstick and sought consult at a clinic. Negative abdominal plain film misled the physician to believe ingested chopstick was digested into fragments and passed out unnoticed. The patient presented acute abdomen caused by duodenal perforation nine months later and was subsequently treated with emergency laparotomy with primary duodenorrhaphy. Conclusions Negative plain films are not sufficient to conclude a conservative treatment in foreign body ingestion. Computed tomography scan or endoscopic examinations should be done to rule out retained foreign body within gastrointestinal tract.

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Foreign Body Ingestion and Aspiration : A Review of Characteristics in Child and Adult Cases

Nihon Kikan Shokudoka Gakkai Kaiho ◽

10.2468/jbes.59.195 ◽

2008 ◽

Vol 59 (2) ◽

pp. 195-195

Author(s):

Y. Oka ◽

K. Asabe ◽

H. Kai ◽

T. Shirakusa

Keyword(s):

Foreign Body ◽

Foreign Body Ingestion

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PREDICTORS FOR FOREIGN BODY PRESENCE AT ENDOSCOPY IN FOREIGN BODY INGESTION - A PROSPECTIVE STUDY

10.26226/morressier.57c53840d462b80296c9c2a7 ◽

2016 ◽

Author(s):

Diogo Libânio

Keyword(s):

Foreign Body ◽

Prospective Study ◽

Foreign Body Ingestion ◽

A Prospective Study

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Unique Pattern of True Foreign-Body Ingestion in the Valley of Kashmir; Sharp Foreign Bodies Outnumbering the Blunt Ones

Journal of Digestive Endoscopy ◽

10.4103/jde.jde_74_18 ◽

2019 ◽

Vol 10 (01) ◽

pp. 028-032

Author(s):

Nisar Ahmad Shah ◽

Showkat Ahmad Kadla ◽

Asif Iqbal Shah ◽

Bilal Ahmad Khan ◽

Inaam Ul Haq ◽

...

Keyword(s):

Foreign Body ◽

Success Rate ◽

Foreign Bodies ◽

Foreign Body Ingestion ◽

Young Females ◽

The People ◽

Early Endoscopy ◽

Normal Individuals ◽

Structural Abnormalities ◽

The Impact

ABSTRACT Background and Aims: Foreign-body ingestion is a common phenomenon, especially in children. In normal adults, foreign-body ingestion is usually accidental and mostly ingestion occurs with food and impaction is a result of structural abnormalities of the upper gastrointestinal tract (UGIT). However, accidental ingestion of nonfood products is unusual; especially ingestion of pins (scarf or safety pins) and needles is unknown. We come across ingestion of these unusual/sharp foreign bodies routinely from the past few years. The aim of this study was to observe, over a period of 1 year, the spectrum of nonfood or true foreign-body ingestion in our community and to see the impact of an early endoscopy on outcome or retrieval of the ingested objects. Materials and Methods: In a prospective observational study, we studied the profile of foreign-body ingestion in normal individuals of all ages and both sexes, excluding the individuals with any structural abnormalities of the gut and the people with psychiatric ailment. Results: Of total 51 patients with foreign-body ingestion, 42 (82%) were 20 or <20 years of age with females constituting 86.3% of the total and males constituting only 13.7%. Foreign bodies ingested included 38 pins (74.5%), seven coins (13.7%), four needles (7.8%), and one denture and a nail (2%) each. Overall 26 (51%) foreign bodies were seen in UGIT (within reach of retrieval) at the time of endoscopy and all of them were retrieved. Nineteen (37.3%) patients reported within 6 h of ingestion, and majority of them (16 = 84.2%) had foreign bodies within UGIT and all of them were removed. Those patients (n = 32; 62.7%) who reported beyond 6 h, only 10 (31.25%) had foreign bodies in UGIT as a result of which the success rate of removal in these patients was only 32%. Conclusion: Most of our patients were young females and the common foreign bodies ingested were sharp including scarf pins followed by coins and needles. The success rate of retrieval was high in those who reported within 6 h of ingestion of foreign body. The rate of retrieval was 100% if foreign body was found on esophagogastroduodenoscopy. Hence, we recommend an early endoscopy in these patients and some alternative to use of scarf pins.

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Sa1232 Endoscopic Management of Foreign Body Ingestion and Food Bolus Impactation: Experience of a Single Referral Center in Brazil

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2017.03.469 ◽

2017 ◽

Vol 85 (5) ◽

pp. AB211

Author(s):

Simone L. Moreira ◽

Carla L. Aluizio ◽

Danielle P. Sampaio ◽

Cristiane k. Nagasako ◽

Maria de Fatima C. Servidoni ◽

...

Keyword(s):

Foreign Body ◽

Foreign Body Ingestion ◽

Endoscopic Management ◽

Food Bolus ◽

Referral Center

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Conservative Management in Two Penetrating Fishbone Injuries: A Case Series and Literature Review

Journal of Clinical and Medical Research ◽

10.37191/mapsci-2582-4333-3(6)-094 ◽

2021 ◽

Keyword(s):

Foreign Body ◽

Literature Review ◽

Conservative Management ◽

Case Reports ◽

Case Series ◽

Foreign Body Ingestion ◽

Medical Referral

Foreign body ingestion is a regular medical referral. Patients present with different objects such as chicken bones, nails, coins, and fishbones. It is usually managed in causality and passes without any intervention. However, occasionally, we come across fishbone complications requiring intervention. We discuss the course and management of two case reports of fishbone injuries in different abdominal regions.

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Foreign Body Ingestion

10.2310/gastro.5503 ◽

2015 ◽

Author(s):

Kunal Jajoo ◽

Allison R Schulman

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Management Strategies ◽

The United States ◽

Foreign Body Ingestion ◽

Gi Tract ◽

Food Bolus ◽

Therapeutic Decisions ◽

Food Bolus Impaction ◽

Bolus Impaction

Foreign-body ingestion and food bolus impaction are common causes of esophageal obstruction, with an annual incidence of 13 cases per 100,000, and represent approximately 4% of all emergency endoscopies. Although the majority of foreign bodies that travel to the gastrointestinal (GI) tract will pass spontaneously, 10 to 20% must be removed endoscopically, and 1 to 5% will require surgery. Key diagnostic and therapeutic decisions are based on common factors, including the type of ingested object, number of objects, timing between ingestion and presentation, anatomic location of the object, and presence or absence of symptoms. Complications relating to foreign-body ingestion are typically uncommon; however, the associated morbidity may be severe and occasionally life threatening, and despite the fact that overall mortality has been extremely low, it has been estimated that up to 1,500 deaths occur annually in the United States as a result of foreign-body ingestion. The initial and follow-up management strategies are crucial to preventing morbidity. This review details the epidemiology, etiology and pathophysiology, diagnosis, management, and complications of foreign-body ingestion. Figures show examples of foreign bodies in the esophagus and stomach, three esophageal areas where a foreign body is likely to be impacted, examples of a meat bolus in the esophagus, radiograph of a patient who swallowed one nail and three batteries, and examples of linear erosions of the esophagus and stomach. Tables list the most common GI pathology predisposing individuals to esophageal foreign-body impaction, timing and management of food bolus impaction and foreign-body ingestion, endoscopic management strategies for food bolus impaction and ingested foreign bodies, and radiographic and surgical management strategies for monitoring progress of foreign-body passage through the GI tract. This review contains 5 highly rendered figures, 4 tables, and 78 references.

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