scholarly journals Causes of upper gastrointestinal tract obstruction

2021 ◽  
Vol 17 (2) ◽  
pp. 105-110
Author(s):  
Tomasz Kurowski ◽  
Bartosz Ostrowski ◽  
Marek Hartleb ◽  
Keyword(s):  
Gastrointestinal Tract ◽  
Foreign Bodies ◽  
Epigastric Pain ◽  
Proximal Part ◽  
Therapeutic Endoscopy ◽  
Upper Gastrointestinal Tract ◽  
Peritoneal Adhesions ◽  
Neoplastic Processes ◽  
Schatzki Ring ◽  
Upper Gastrointestinal

Obstruction of the upper gastrointestinal tract, caused by blocked passage in the oesophagus, stomach or duodenum, is an important clinical and diagnostic problem in gastroenterological practice. The typical symptoms are dysphagia, postprandial vomiting, epigastric pain and weight loss. Post-inflammatory oesophageal lesions associated with reflux oesophagitis are the most common cause of obstruction. Other common causes include foreign bodies, neoplasms, chemical burns of the oesophagus and radiation-induced stenosis. In more than 2/3 cases, foreign bodies are localised in the proximal part of the oesophagus, but anatomical abnormalities, such as a Schatzki ring or post-inflammatory stenosis, increase the risk of food bolus impaction in the distal part of the oesophagus. Radiotherapy of head and neck tumours may cause stenosis, which affects more than 7% of patients treated this way. For the stomach and duodenum, 50–80% of obstruction cases are associated with neoplastic processes, with gastric cancer and pancreatic adenocarcinoma accounting for 35% and 15–25% of these cases, respectively. Mild causes of peripyloric obstruction include gastric and duodenal peptic ulcer, peritoneal adhesions, gastric polyps and Crohn’s disease. Symptoms of temporary pylorus obstruction can be caused by large, gastric hyperplastic pedunculated polyps. Therapeutic endoscopy is the most commonly used method for upper gastrointestinal tract obstruction. Depending on the cause, it involves foreign body removal, balloon enteroscopy, stenting with self-expanding metallic stents, and, in the case of treatment failure, surgical resection or palliative gastrojejunostomy.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: Report on a Series of 414 Adult Patients

Endoscopy ◽  
2001 ◽  
Vol 33 (8) ◽  
pp. 692-696 ◽  
Author(s):  
S. Mosca ◽  
G. Manes ◽  
R. Martino ◽  
L. Amitrano ◽  
V. Bottino ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Foreign Bodies ◽  
Adult Patients ◽  
Upper Gastrointestinal Tract ◽  
Endoscopic Management ◽  
Upper Gastrointestinal

scholarly journals Endoscopic Management of Foreign Body Impaction in the Upper Gastrointestinal Tract in a Tertiary Care Centre of Nepal

2020 ◽  
Vol 18 (2) ◽  
pp. 36-40
Author(s):  
A. Shrestha ◽  
R.B. Gurung ◽  
P. Sharma ◽  
R. Shrestha ◽  
P. Shrestha
Keyword(s):  
Gastrointestinal Tract ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Tertiary Care ◽  
Upper Gastrointestinal Tract ◽  
Endoscopic Management ◽  
Tertiary Care Centre ◽  
Male Predominance ◽  
Foreign Body Impaction ◽  
Upper Gastrointestinal

Background Ingested foreign body impaction on upper gastrointestinal tract is common incidence among children, older age group, mentally challenged individuals, and people the influence of alcohol. In most cases, the foreign bodies pass spontaneously and uneventfully but when this does not occur; endoscopic management to ensure removal under direct visualization is required. Relief upon removal of foreign body and prevention of complications is essential. Objective To assess the endoscopic management and outcome of foreign body impacted in the upper gastrointestinal tract. Method This is a hospital based observational retrospective cross sectional study involving 165 patients at Endoscopy Department of Dhulikhel Hospital in Nepal between November 2015 and October 2019. The data regarding the demographic profile, clinical characteristics and endoscopic findings were retrieved and analyzed to determine endoscopic interventions performed, complications and outcomes. Result One hundred and sixty five patients presenting with history of ingestion of foreign body were included in the study. The mean age of the patients was 46.8 ± 19.1 years with male predominance (60%). The most common site of foreign body impaction was oesophagus (70%). The most common foreign body encountered was bone (62.2%) among which chicken bones (91.1%) were most frequent. For the retrieval of sharp-pointed foreign bodies, rat forceps and graspers (45.7%) were most commonly used. Total 14 cases required rigid oesophagoscopy as the foreign body could not be retrieved by flexible endoscopy. Conclusion Foreign body ingestion and its impaction in the upper gastrointestinal tract has been found to be common in endoscopic practise. Early detection and timely removal of foreign bodies is of utmost importance to avoid discomfort to the patient as well as to ensure successful removal without complications.

scholarly journals Clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dong Ryeol Yoo ◽  
Chang Bin Im ◽  
Baek Gyu Jun ◽  
Hyun Il Seo ◽  
Jong Kyu Park ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
Foreign Bodies ◽  
Early Recognition ◽  
Upper Gastrointestinal Tract ◽  
Endoscopic Management ◽  
Endoscopic Removal ◽  
Foreign Objects ◽  
Upper Gastrointestinal

Abstract Background Ingested foreign objects frequently require emergency removal. This study aimed to investigate the clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract and the risk factors for adverse events. Methods Adults (> 18 years) who underwent endoscopic management of ingested foreign bodies at two centers, one inland and one on the coast, between January 2008 and December 2017 were eligible. Clinical characteristics and procedure-related outcomes were retrospectively reviewed. Patients were divided into two groups, based on whether the foreign bodies were sharp or blunt in shape. Results A total of 853 patients aged 19–96 years were analyzed. Ingestion of fish bones was more common in the coastal area, whereas ingestion of food boluses was more common in the inland area. The duration of impaction ranged from 1 h to over 1 month and was significantly longer in patients who ingested blunt than sharp foreign bodies (15 vs. 5 h, p < 0.001). Most (98.9%) foreign bodies were successfully removed. Adverse events occurred in 31.2 % of patients, including ulcers (4.0%) and perforations (3.3 %). Multivariate analysis showed that age (odds ratio [OR] 1.015, p = 0.012), sharp foreign bodies (OR 5.133, p < 0.001), location in the esophagus (OR 2.723, p = 0.018), and duration of impaction (OR 1.431, p < 0.001) were factors associated with adverse events. Conclusions Early recognition and timely endoscopic removal of ingested foreign bodies, particularly in elderly patients and those with sharp foreign bodies, may improve clinical outcomes.

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