Spectrum of imaging findings in trans-gastric migration of accidently ingested metallic foreign bodies

Background: An accidently ingested foreign body may get lodged within the lumen of gastrointestinal tract, pass uneventfully with feces or may migrate extraluminally into the surrounding tissues in which case it may lead to suppurative or vascular complications. The aim of the endeavor was to study the spectrum of imaging findings in patients with accidental ingestion of foreign bodies with trans-gastric migration of metallic foreign bodies.Methods: Total 33 patients with history of accidental ingestion of foreign bodies were subjected to preliminary radiograph of neck, chest and abdomen followed by upper gastrointestinal endoscopy. Failure to retrieve/ localize foreign body endoscopically from upper gastrointestinal tract with check radiograph reiterating the presence of foreign body in upper abdomen were subjected to computed tomography of abdomen.Results: A total of 33 patients comprising of 27 females and 6 males with mean age of 23.76 years with history of foreign body ingestion were studied. Ingested foreign bodies were lodged in pharynx (n=7), esophagus (n=3), stomach (n=13) or duodenum (n=3). In 7 patients in whom endoscopy failed to locate and/or retrieve foreign body, computed tomography confirmed the presence of trans-gastrically migrated foreign body in the surrounding structures. The location of migrated foreign bodies was in lesser sac (n = 2), greater omentum (n = 3), lesser omentum (n = 1) and transmural (n = 1). Two patients had evidence of collection formation around the migrated foreign bodies.Conclusions: Sharp or pointed metallic foreign bodies may migrate trans-luminally with various implications. Though radiography is the preliminary workhorse for the confirmation of ingested foreign bodies, computed tomography owing to its volumetric data acquisition helps in exact localization of migrated foreign bodies and should precede any therapeutic intervention for retrieval of migrated foreign bodies.

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Endoscopic management of foreign bodies in the upper gastrointestinal tract

International Surgery Journal ◽

10.18203/2349-2902.isj20174105 ◽

2017 ◽

Vol 4 (10) ◽

pp. 3277

Author(s):

Pramod Mirji ◽

Vikas Daddenavar ◽

Eshwar Kalburgi

Keyword(s):

Gastrointestinal Tract ◽

Foreign Body ◽

Foreign Bodies ◽

Flexible Endoscopy ◽

Definitive Treatment ◽

Endoscopic Management ◽

Food Bolus Impaction ◽

Bolus Impaction ◽

Age Range ◽

Upper Gastrointestinal

Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 2 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body (FB) ingestion admitted to department of general surgery from January 2015 to December 2016 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 23 cases were studied. Age range was 2-75 years. Males were predominant (60.87%). Coins were found most commonly (52.17%). Esophagus was the commonest site of FB lodgment (65.22%). Upper esophagus being the most common (39.13%). Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 23 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.

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

Kathmandu University Medical Journal ◽

10.3126/kumj.v18i2.33223 ◽

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.

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Migration of a Swallowed Blunt Foreign Body to the Neck

Case Reports in Otolaryngology ◽

10.1155/2014/646785 ◽

2014 ◽

Vol 2014 ◽

pp. 1-2

Author(s):

Kerem Ozturk ◽

Goksel Turhal ◽

Sercan Gode ◽

Atilla Yavuzer

Keyword(s):

Computed Tomography ◽

Foreign Body ◽

Primary Closure ◽

Foreign Bodies ◽

Barium Swallow ◽

X Rays ◽

Upper Aerodigestive Tract ◽

Computed Tomography Scans ◽

History Of ◽

The Right

Ingestion of foreign bodies is a common problem in the otolaryngology practice. Reports of extraluminal migration of the foreign bodies from the upper aerodigestive tract are rare. Penetration and extraluminal migration of ingested foreign bodies may cause severe vascular and suppurative complications, even death. We report a 4-year-old girl who presented with a mass and partial extrusion of a foreign body in the neck. She had a history of ingesting the plastic top piece of a knitting needle approximately 1 year ago. She had been asymptomatic until the present time. The examination revealed a red, blunt, rectangular plastic foreign body half embedded in the skin of the right neck. Esophagography with barium swallow, cervical X-rays, and computed tomography scans were obtained. The foreign body was easily removed under general anesthesia. Primary closure and direct laryngoscopy was also performed. The patient recovered very well without any complications.

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Endoscopic management of foreign bodies in the upper gastrointestinal tract

International Surgery Journal ◽

10.18203/2349-2902.isj20202826 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2226

Author(s):

Sandip Kumar S. Chaudhari ◽

Sonalben M. Chaudhary

Keyword(s):

Gastrointestinal Tract ◽

Foreign Body ◽

Foreign Bodies ◽

Flexible Endoscopy ◽

Foreign Body Ingestion ◽

Definitive Treatment ◽

Endoscopic Management ◽

Food Bolus Impaction ◽

Bolus Impaction ◽

Upper Gastrointestinal

Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 5 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body ingestion admitted to department of general surgery from March 2015 to March 2020 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 55 cases were studied. Age range was 1-85 years. Males were predominant 61.81%. Coins were found most commonly 63.6%. Esophagus was the commonest site of FB lodgement 70.9%. Upper esophagus being the most common 36.36%. Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 55 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.

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Successful Endoscopic Management of Suspected Foreign Bodies in Upper Gastrointestinal Tract among Patients Undergoing Upper Gastrointestinal Endoscopy in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6714 ◽

2021 ◽

Vol 59 (239) ◽

Author(s):

Ramila Shrestha ◽

Shankhar Baral ◽

Mukesh Sharma ◽

Jiwan Thapa ◽

Dibas Khadka

Keyword(s):

Gastrointestinal Tract ◽

Foreign Body ◽

Foreign Bodies ◽

Cross Sectional Study ◽

Upper Gastrointestinal Tract ◽

Care Hospital ◽

Endoscopic Removal ◽

Sectional Study ◽

Cross Sectional ◽

Upper Gastrointestinal

Introduction: Most ingested foreign bodies pass through the gastrointestinal tract spontaneously. However, some foreign bodies may get impacted in the upper gastrointestinal tract. A variety of endoscopic techniques and instruments are indicated for the removal of such impacted foreign bodies. This study was conducted to find out the prevalence of successful endoscopic removal of foreign bodies. Methods: This descriptive cross-sectional study was conducted among patients who presented at the Department of Gastroenterology with complaints of upper gastrointestinal foreign body ingestion from 2/11/2008 to 23/07/2020 after taking ethical approval of the research proposal was taken from Institutional Review Board (Reference no 13). Convenient sampling was done. The data were entered into Microsoft Excel and analyzed in Statistical Package of Social Sciences version 22. Results: A total of 119 cases were identified with foreign bodies ingestion. In hundred patients, foreign bodies 100 (84 %) (77.41-90.58 at 95% Confidence Interval) were extracted completely. Complete extraction failed in 19 (16%) patients. Six (5%) patients were treated by push technique and 10 (8.4%) patients with failed retrieval, received surgical intervention for foreign body removal. Conclusions: Endoscopic removal technique of foreign bodies in the upper gastrointestinal tract was successful in most of the cases and is associated with few complications.

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Bulimia and oesophageal foreign bodies

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002442 ◽

2008 ◽

Vol 122 (7) ◽

Cited By ~ 6

Author(s):

A Sastry ◽

P D Karkos ◽

S Leong ◽

S Hampal

Keyword(s):

Anorexia Nervosa ◽

Foreign Body ◽

Foreign Bodies ◽

Accidental Ingestion ◽

History Of ◽

Repeated Pattern ◽

Rigid Oesophagoscopy ◽

Operative Recovery

AbstractObjectives:To demonstrate the importance of a detailed history when assessing patients with a repeated pattern of foreign body ingestion.Case report:A 19-year-old woman presented to our department following accidental ingestion of a teaspoon. On further questioning, she admitted to a habit of binge-eating followed by self-induced vomiting, in order to avoid weight gain; she blamed this behaviour on a stressful relationship with her partner. She also had one previous episode of accidental ingestion of a plastic spoon, which had been removed by oesophagogastroduodenoscopy. The patient underwent an uneventful rigid oesophagoscopy and foreign body removal. During post-operative recovery, she admitted that she had suffered for years with bulimia and anorexia nervosa. She was discharged home after appropriate psychiatric counselling, and follow up was arranged.Conclusions:Oesophageal foreign bodies are commonly encountered in otolaryngology practice. Such circumstances are often compounded by pre-existing psychiatric problems such as bulimia and/or anorexia nervosa. Patients with bulimia may often present with a very similar pattern of multiple episodes of ingestion of large foreign bodies. Identification of this eating disorder (especially when there is a recurrent history of large, accidentally ingested foreign bodies) and prompt psychiatric referral is essential for efficient long-term management of this condition.

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Effectiveness of flexible endoscopy in the management of upper gastrointestinal tract foreign bodies at a tertiary hospital of western Nepal

Journal of Chitwan Medical College ◽

10.3126/jcmc.v10i1.28060 ◽

2020 ◽

Vol 10 (1) ◽

pp. 3-7

Author(s):

Shatdal Chaudhary ◽

Prabin Khatri ◽

Suresh Shrestha

Keyword(s):

Gastrointestinal Tract ◽

Foreign Body ◽

Foreign Bodies ◽

Flexible Endoscopy ◽

Tertiary Hospital ◽

Upper Gastrointestinal Tract ◽

Endoscopic Management ◽

Cross Sectional ◽

Clinical Scenarios ◽

Upper Gastrointestinal

Background: Foreign body ingestions are some of the most challenging clinical scenarios faced by gastrointestinal endoscopists. The commonly ingested foreign bodies are coins, toys, and batteries in children whereas bone or meat boluses are common in adults. The present study was carried out to study the clinical profile of patients presenting with foreign body in the upper gastrointestinal tract and effectiveness of endoscopy as a therapeutic tool in its management. Methods: A descriptive cross-sectional study was carried out in the endoscopy unit of Universal College of Medical Sciences, Bhairahawa, Nepal from Jan 2015 to Dec 2018. All patients who underwent endoscopy with suspicion of ingestion of foreign body in the upper gastrointestinal tract were enrolled in this study. Foreign body was removed with appropriate endoscopic tools. Results: Sixty-four patients were enrolled in the present study with mean age of 34.78±21.84 years. There were 42.19% (n=27) males with female preponderance (57.37%, n=37). Retrosternal discomfort with dysphagia was the most common presentations seen in 68.75% (n=44) patients. The most common site for foreign body impaction was lower oesophagus (53.13%). Three most common foreign bodies encountered were meat bone, meat balls and coins respectively. Endoscopic management was successful in 59 (92.19%) patients. Conclusions: Foreign body ingestion is commonly seen in children and young adults with female predominance. Most common upper gastrointestinal foreign bodies are related to food bolus impaction with animal bone or meat. Therapeutic endoscopy is a safe and effective method for removing foreign body from upper gastrointestinal tract.

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Tapering body stiffness shortens upper gastrointestinal examination via transoral insertion with ultrathin endoscope

Endoscopy International Open ◽

10.1055/a-1266-3203 ◽

2020 ◽

Vol 08 (12) ◽

pp. E1748-E1753

Author(s):

Satoshi Ono ◽

Shun Ito ◽

Kyohei Maejima ◽

Shosuke Hosaka ◽

Kiyotaka Umeki ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Past History ◽

Insertion Time ◽

Trade Off ◽

Examination Time ◽

Total Examination Time ◽

History Of ◽

Food Residues ◽

Gastrointestinal Examination ◽

Upper Gastrointestinal

Abstract Background and study aims Ultrathin endoscopes are commonly used for surveillance esophagogastroduodenoscopy (EGD) to reduce discomfort associated with scope insertion. However, the flexibility of an ultrathin endoscope is a trade-off between reducing discomfort and lengthening examination time. Patients and methods The EG17-J10 (EG17) is a novel ultrathin endoscope characterized by its tapering body stiffness; however, the flexibility of its tip is comparable to that of the traditional ultrathin endoscope EG16-K10 (EG16). We compared EGD examination time between EG17 and EG16. A total of 319 examinees who underwent EGD from November 2019 to January 2020 at the Chiba-Nishi General Hospital were enrolled. Six examinees were excluded due to past history of surgical resection of the upper gastrointestinal tract or too much food residues; 313 examinees (EG17, 209; EG16,104) were retrospectively analyzed. The examination time was divided into three periods: esophageal insertion time (ET), gastroduodenal insertion time (GDT), and surveillance time of the stomach (ST). The total amount of ET, GDT, and ST was defined as total examination time (TT). Results TT of EGD using EG17 was significantly shorter compared to EGD using EG16 (222.7 ± 68.9 vs. 245.7 ± 78.5 seconds) (P = 0.004). Among the three periods of examination time, ET (66.7 ± 24.1 vs. 76.0 ± 24.1 seconds) (P = 0.001) and GDT (47.9 ± 17.4 vs. 55.2 ± 35.2 seconds) (P = 0.007) of EGD using EG17 were significantly shorter compared to EGD using EG16, except for ST (108.1 ± 51.5.1 vs. 114.5 ± 50.1 seconds) (P = 0.148). Conclusion An ultrathin endoscope with tapering body stiffness can shorten EGD examination time, mainly due to the shortening of insertion time.

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