scholarly journals 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

2021 ◽  
Vol 59 (239) ◽  
Author(s):  
Ramila Shrestha ◽  
Shankhar Baral ◽  
Mukesh Sharma ◽  
Jiwan Thapa ◽  
Dibas Khadka

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.

2021 ◽  
Author(s):  
Fariborz Mansour-Ghanaei ◽  
Alireza Gharib Pour ◽  
Farahnaz Joukar ◽  
Alireza Mansour-Ghanaei ◽  
Masood Sepehrimanesh ◽  
...  

Abstract Purpose: Precancerous lesions of the UGI tract are the second major cancer-related deaths and responsible for more than ten percent of cancer-related deaths worldwide. The aim of this study was to evaluate the frequency of precancerous lesions in the upper gastrointestinal tract of patients under patronage of Imam Khomeini Relief Foundation in Guilan province as vulnerable population. Methods: In a cross-sectional study from March 2017 to March 2018, three hundred patients under patronage of Guilan branch of Imam Khomeini Relief Foundation aged more than 40 years were enrolled. All patients were underwent endoscopy and checked for Helicobacter pylori infection. Results: The most frequent lesions in the esophagus, stomach and bulb were grade A mucosal breaking (58.7%), erosions (57.0%), and ulcers (6.3%), respectively. Esophageal lesions were higher in the age more than 60 years (P=0.036). Smokers and patients with familial history of cancers in the 2ndand 3rd grade of relatives had more lesions in the bulb (P=0.005 and P=0.010, respectively). Female patients, those with age lower than 50 years and no-smoker had lower frequency of intestinal metaplasia (IM) (P=0.024, P=0.030, and P=0.003, respectively). Also, there was positive association between gastric atrophy and age (P=0.009). Furthermore, chronic active gastritis were seen more frequently in male patients (P=0.003) and smokers (P=0.010). Significant positive association between consumption of fish meat and occurrence of IM was detected (P=0.010). Conclusions: Male gender, higher age and smoking for IM and male gender, higher BMI and smoking for H. pylori infection were the predictive risk factors. It seems early diagnosis of precancerous lesions help to prevent cancers and to increase the survival rate.


2020 ◽  
Vol 10 (1) ◽  
pp. 3-7
Author(s):  
Shatdal Chaudhary ◽  
Prabin Khatri ◽  
Suresh Shrestha

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.


2020 ◽  
Vol 18 (2) ◽  
pp. 36-40
Author(s):  
A. Shrestha ◽  
R.B. Gurung ◽  
P. Sharma ◽  
R. Shrestha ◽  
P. Shrestha

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dong Ryeol Yoo ◽  
Chang Bin Im ◽  
Baek Gyu Jun ◽  
Hyun Il Seo ◽  
Jong Kyu Park ◽  
...  

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.


2020 ◽  
Vol 48 ◽  
Author(s):  
Franco Metzker Poggiani ◽  
Rodrigo Pereira da Costa Duarte ◽  
Marcelo Ismar Silva Santana ◽  
Paula Diniz Galera

Background: Dogs and cats with acute signs of choking, retching, cough, vomiting, regurgitation, hypersalivation, dysphagia and odynophagia should have the presence of a gastrointestinal foreign body (FB) as part of their differential diagnosis, where it is a frequent condition in the care of small animals. Most objects lodged in the esophagus, stomach, and proximal duodenum can be removed by upper digestive endoscopy, a curative, little invasive procedure. The objective of our study was to evaluate the physical aspects and location of esophageal and gastric FBs observed in 88 dogs and the age and breed of the affected animals and to determine the success rate and eventual complications associated with the procedure as well.Materials, Methods & Results: Eighty-eight cases of dogs, males and females of varying ages and breeds, submitted to upper digestive endoscopy were selected because of suspicion of esophageal or gastric FBs. The endoscopic procedure aimed at confirming the diagnosis, whether or not followed by endoscopic removal of these objects. Prior to endoscopy, the animals had laboratory tests (blood count and serum biochemistry) and subsequently to the anesthetic protocols of choice for each case. Data including breed, age, type of constituent material and anatomical location of the FB, endoscopic procedure success rate and complications were recorded and descriptively evaluated. Of the 88 dogs evaluated, 60% (n = 53) were male and 40% (n = 35) female. According to the breed of the animals, 55% (n = 49) were small-breed dogs, 29% (n = 25) large-breed dogs, and 8% (n = 7) medium-breed dogs, and 8% were of mixed breed dogs, which could assume various sizes. Shih Tzus accounted for 18% (n = 16) of the animals, Lhasa apsos 8% (n = 7) and mixed breed 8% (n = 7), where these were the most frequently affected breeds. Regarding age, animals 1 to 5 years old represented 66% (n = 58) of the patients, and those 6 to 10 years old accounted for 20% (n = 18), while 11% of the dogs were over 10 years old (n = 10). Two animals (3%) had no information about their ages. Pieces of cloth were the most frequently found FBs, representing 20%(n = 20), followed by animal bones (19%) and fruit pits (10%). As for location, 78% (n = 69) of the FBs were located in the stomach and 22% (n = 19) in the esophagus. The success rate of endoscopic FB removal in this study was 83% (n = 73). In 76% (n = 67) of the animals, there were no complications due to the presence of FB in the upper gastrointestinal tract. The most frequent complications were esophageal ulcerations (n = 7) and the inability to move the FB (n = 5) and adherences. (n = 4).Discussion: The results showed that small-breed dogs, especially Shih Tzus and Yorkshires, represented a larger number of cases, probably due to their popularity in Brazil, where the study was conducted. Males were more prevalent than females, and the most affected age was between 1 and 5 years, with emphasis on younger animals. There were more gastric FB cases compared to esophageal FB cases, which was related to the interval between the ingestion of the object and veterinary care. Although not the most prevalent FB, the high rate of mango pits can be explained by the vast number of mango trees in the Federal District. There were few complications compared to the success of cases, indicating that endoscopy is the procedure of choice for the diagnosis and removal of FBs from the gastrointestinal tract.


2020 ◽  
Vol 59 (233) ◽  
Author(s):  
Subash Bhattarai ◽  
Merina Gyawali ◽  
Sudeep Regmi

Introduction: Gastric cancer is a common malignancy of the upper gastrointestinal tract. Gastric cancer is a common cause of death worldwide. This research aimed to study the prevalence of gastric cancer among patients undergoing upper gastrointestinal endoscopies. Methods: A descriptive, cross-sectional study was conducted in the Department of Medicine at Manipal Teaching Hospital, Nepal, from January 2018 to June 2020. A total of 2640 subjects underwent upper gastrointestinal endoscopies over the study period. Ethical approval was taken from the institutional review committee of Manipal College of Medical Sciences (MEMG/ IRC/ 383/GA). Data were analyzed by SPSS version 20. Results: The prevalence of gastric cancer among patients undergoing UGI endoscopies was 2.4%. The mean age of subjects was 58 ± 12.35 years (range of 31 to 96 years) with male predominance (M:F=1.9:1). Antrum was the most common site for gastric carcinoma. The most common morphology was ulcerative growth (61.6%). Adenocarcinoma (98.4%) was the most common histology, and the majority was of intestinal subtype (56.3%). Conclusions: Gastric cancer is not an uncommon finding in patients undergoing UGI endoscopies. Gastric cancers were commonly seen above 50 years of age and predominant in males. Patients with gastric carcinoma usually present late with advanced disease stages and unfavorable histopathology.


Author(s):  
Manju Surendran ◽  
K Sunil Kumar

Introduction: Acute Upper Gastrointestinal (UGI) bleed is a common potentially life threatening emergency. The aetiological profile of bleed and prognosis varies according to geographical region and availability of endoscopic facilities. Aim: To determine the clinical and endoscopic profile of UGI bleed, risk factors and prognosis in the patients. Materials and Methods: This was a cross-sectional study conducted over a period of 12 months at a tertiary care centre in Southern India. Patients admitted with history of hematemesis and melena, satisfying the inclusion criteria was taken consecutively. Clinical and endoscopic profile were noted and followed-up for six weeks. Statistical analysis was performed using chi-square test for qualitative variables and independent t-test for quantitative variables. Significance level was fixed as p-value of <0.05. Results: A total of 138 patients were studied in this period. The male to female ratio in the study was 3.5:1. The mean age was 53.5±13.17 years. The most common clinical presentation was hematemesis in 57 patients (41.3%) followed by haematemesis and melena in 46 patients (33.3%). The most common cause on endoscopy was portal hypertension-related oesophageal and gastric varices (51.4%) followed by antral gastritis (15.2%). The cause of UGI bleeding could not be identified in 5.1% in which the endoscopy was normal. Haemogram, platelet count and serum albumin were significantly lower in variceal bleed group, compared to non-variceal group. Eleven patients succumbed to death secondary to UGI bleed. Conclusion: The most common causes of UGI bleed are portal hypertension related gastric and oesophageal varices. The in-hospital mortality in the study was 7.9%.


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