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

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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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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Gastric perforation secondary to ingestion of a plastic bag

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0036 ◽

2016 ◽

Vol 98 (2) ◽

pp. e29-e30 ◽

Cited By ~ 1

Author(s):

YM Goh ◽

IM Shapey ◽

K Riyad

Keyword(s):

Clinical Practice ◽

Gastrointestinal Tract ◽

Foreign Body ◽

Foreign Bodies ◽

Gastric Perforation ◽

Foreign Body Ingestion ◽

Pathophysiological Process ◽

Common Presentation ◽

Plastic Bag ◽

Pass Through

Foreign body ingestion is a common presentation in clinical practice, seen predominantly in children. Most foreign bodies pass through the gastrointestinal tract without any additional morbidity. We present a case of gastric perforation secondary to the ingestion of a small plastic bag. We discuss the likely pathophysiological process underlying perforation secondary to plastic bag ingestion, which is most commonly associated with the concealment of narcotics.

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Acute obstructive cholangitis due to fishbone in the common bile duct: a case report and review of the literature

BMC Gastroenterology ◽

10.1186/s12876-019-1088-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Min Yu ◽

Bowen Huang ◽

Ye Lin ◽

Yuxue Nie ◽

Zixuan Zhou ◽

...

Keyword(s):

Foreign Body ◽

Bile Duct ◽

Literature Review ◽

Foreign Bodies ◽

Present Review ◽

Foreign Body Ingestion ◽

Clinical Value ◽

The World ◽

Obstructive Cholangitis ◽

Post War

Abstract Background Choledocholithiasis is an endemic condition in the world. Although rare, foreign body migration with biliary complications needs to be considered in the differential diagnosis for patients presenting with typical symptoms even many years after cholecystectomy, EPCP, war-wound, foreign body ingestion or any other particular history before. It is of great clinical value as the present review may offer some help when dealing with choledocholithiasis caused by foreign bodies. Case presentation We reported a case of choledocholithiasis caused by fishbone from choledochoduodenal anastomosis regurgitation. Moreover, we showed up all the instances of choledocholithiasis caused by foreign bodies published until June 2018 and wrote the world’s first literature review of foreign bodies in the bile duct of 144 cases. The findings from this case suggest that the migration of fishbone can cause various consequences, one of these, as we reported here, is as a core of gallstone and a cause of choledocholithiasis. Conclusion The literature review declared the choledocholithiasis caused by foreign bodies prefer the wrinkly and mainly comes from three parts: postoperative complications, foreign body ingestion, and post-war complications such as bullet injury and shrapnel wound. The Jonckheere-Terpstra test indicated the ERCP was currently the treatment of choice. It is a very singular case of choledocholithiasis caused by fishbone, and the present review is the first one concerning choledocholithiasis caused by foreign bodies all over the world.

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Tendency to Ingest Foreign Bodies in Mentally Retarded Patients: A Case with Ileal Perforation Caused by the Ingestion of a Teaspoon

Case Reports in Surgery ◽

10.1155/2016/8075432 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

İhsan Yıldız ◽

Yavuz Savaş Koca ◽

Gökhan Avşar ◽

İbrahim Barut

Keyword(s):

Mental Retardation ◽

Foreign Body ◽

Foreign Bodies ◽

Mentally Retarded ◽

The Body ◽

Foreign Body Ingestion ◽

Emergency Laparotomy ◽

Ileal Perforation ◽

History Of ◽

The Right

Introduction. Unintentional foreign body ingestion commonly occurs accidentally in children aged between 3 months and 6 years and at advanced ages or results from psychiatric disorders such as hallucination in patients with mental retardation. Most of the ingested foreign bodies are naturally discharged from the body but some of them may require surgical intervention.Presentation of Case. A 29-year-old mentally retarded female patient was admitted to the emergency service with a two-day history of abdominal pain, nausea, and vomiting. Physical examination revealed abdominal tenderness, defense, and rebound on palpation. Radiological examination revealed diffuse air-fluid levels and a radiopaque impression of a metal object in the right upper quadrant. The metal teaspoon causing ileal perforation was extracted by emergency laparotomy. On postoperative day 7, the patient was uneventfully discharged following a psychiatric consultation.Discussion. Foreign body ingestion can occur intentionally in children at developing ages and old-age patients, or adults and prisoners, whereas it may occur unintentionally in patients with mental retardation due to hallucination. However, repeated foreign body ingestion is very rare in individuals other than mentally retarded patients.Conclusion. Mentally retarded patients should be kept under close surveillance by surgeons and psychiatrists due to their tendency to ingest foreign bodies.

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Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.6-wit.4858 ◽

2021 ◽

Vol 37 (6-WIT) ◽

Author(s):

Na Liu

Keyword(s):

Foreign Body ◽

Success Rate ◽

Digestive Tract ◽

Nursing Care ◽

Foreign Bodies ◽

Nursing Intervention ◽

Image Guided ◽

Upper Digestive Tract ◽

Endoscopic Image ◽

Upper Gastrointestinal

Objective: This study used phased array imaging algorithm to explore the epidemiological characteristics of endoscopic treatment of upper gastrointestinal foreign bodies to provide a basis for nursing intervention. Methods: We collected data on the age, sex, cause, type of foreign body, success rate of removal, retention location, time and complications of patients with foreign bodies in the upper gastrointestinal tract who were treated in the emergency department of the Digestive Endoscopy Center in our hospital. The study was conducted from January 2018 to December 2020 and we also performed statistical analysis. Results: The high incidence of foreign bodies in the upper digestive tract was in 45 years old to 74 years old patients. The foreign body types were mostly food balls and sharp foreign bodies, accounting for 37.0% and 44.2%, respectively. The cause was misuse and the most accounted for 52.1%, followed by oesophageal pathological stenosis which accounted for 45.5%. The oesophagus in the retention site accounted for up to 80.0%, and the success rate of foreign body extraction was 96.4%. The complications of patients with foreign body retention within twenty four our retention were mainly esophageal scratches and traumatic esophagitis, accounting for 48.5%. 39.6%. Conclusion: There are high risks in the treatment of foreign bodies in the upper digestive tract. Targeted, prospective, and streamlined nursing interventions can provide patients with fast and professional medical care services and minimize patient pain. doi: https://doi.org/10.12669/pjms.37.6-WIT.4858 How to cite this:Liu N. Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications. Pak J Med Sci. 2021;37(6):1636-1640. doi: https://doi.org/10.12669/pjms.37.6-WIT.4858 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Wire bristle foreign body: Never in the same place twice

SAGE Open Medical Case Reports ◽

10.1177/2050313x19853443 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1985344

Author(s):

Andrew DP Prince ◽

Ashley M Bauer ◽

Yanjun Xie ◽

Mark EP Prince

Keyword(s):

Foreign Body ◽

Emergency Room ◽

Computerized Tomography ◽

Foreign Bodies ◽

Aerodigestive Tract ◽

Common Reason ◽

Foreign Body Ingestion ◽

Upper Aerodigestive Tract ◽

Close Proximity

Foreign body ingestion is a common reason for visiting the emergency room. Foreign bodies can lodge anywhere in the upper aerodigestive tract and can sometimes be difficult to extract. Wire bristles that dislodge from grill-cleaning wire brushes and which are then accidentally swallowed can be particularly challenging to remove due to their small size, propensity to become embedded, and their ability to migrate through tissues. This case reveals the speed with which wire bristle foreign bodies can migrate through tissues and exemplifies the need to obtain computerized tomography evaluations in close proximity to any planned attempt to remove them.

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Predictors of Recurrent Ingestion of Gastrointestinal Foreign Bodies

Canadian Journal of Gastroenterology ◽

10.1155/2013/671273 ◽

2013 ◽

Vol 27 (1) ◽

pp. e1-e4 ◽

Cited By ~ 16

Author(s):

Ian C Grimes ◽

Bret J Spier ◽

Lisa R Swize ◽

Mary J Lindstrom ◽

Patrick R Pfau

Keyword(s):

Risk Factors ◽

Foreign Body ◽

Psychiatric Disorder ◽

Foreign Bodies ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Foreign Body Ingestion ◽

Gastrointestinal Pathology ◽

Male Sex ◽

Gastrointestinal Foreign Bodies

BACKGROUND: Gastrointestinal foreign bodies are commonly encountered; however, little knowledge exists as to the causes of foreign body ingestions and why they occur repeatedly in some patients.OBJECTIVE: To identify and define patients at high risk for recurrent foreign body ingestion.METHODS: A retrospective chart review of foreign body ingestion was conducted at a tertiary care medical centre over an 11-year period. Variables analyzed included age, sex, incarceration status,Diagnostic and Statistical Manual of Mental Disorders-IVdiagnosis, success of endoscopy, type of sedation used, method of extraction, complications, presence of gastrointestinal pathology, and incidence of recurrent food impaction or foreign body.RESULTS: A total of 159 patients with a foreign body ingestion were identified. One hundred fourteen (77%) experienced a single episode of ingestion and 45 (23%) experienced multiple ingestions. Of the patients with multiple ingestions, 27 (60%) had recurrent food impactions while 18 (40%) ingested foreign objects. In the recurrent ingestor group, a psychiatric disorder had been diagnosed in 16 patients (35.6%) and there were 13 incarcerated individuals (28.9%). The average number of recurrences was 2.6 per patient (117 total recurrences). Individuals with a psychiatric disorder experienced 3.9 recurrences per patient, while prisoners averaged 4.1 recurrences per patient. The combination of a psychiatric disorder and being incarcerated was associated with the highest recurrence rate (4.33 per patient). Multivariable logistic regression revealed that male sex (OR 2.9; P=0.022), being incarcerated (OR 3.0; P=0.024) and the presence of a psychiatric disorder (OR 2.5; P=0.03) were risk factors for recurrent ingestion.CONCLUSION: Risk factors for recurrent ingestion of foreign bodies were male sex, being incarcerated and the presence of a psychiatric disorder.

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Ingestion of razor blades, a rare event: a case report in a psychiatric patient

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa094 ◽

2020 ◽

Vol 2020 (5) ◽

Author(s):

Jhony Alejandro Delgado Salazar ◽

Natalia Carolina Naveda Pacheco ◽

Paola Alexandra Palacios Jaramillo ◽

Santiago Danilo Garzón Yépez ◽

Victor Rafael Medina Loza ◽

...

Keyword(s):

Foreign Body ◽

Psychiatric Patient ◽

Foreign Bodies ◽

Psychiatric Patients ◽

Rare Event ◽

Rare Condition ◽

Foreign Body Ingestion ◽

Medical Attention ◽

Close Monitoring ◽

Sharp Foreign Body

Abstract Foreign body ingestion is a common condition in clinical practice, thankfully most of the cases do not require any surgery as most foreign bodies can pass through the bowel without injuring it. Treatment depends on the size and kind of foreign bodies. When complications arise, patients may require urgent medical attention. Self-harm by sharp foreign body ingestion is a rare event that must always be promptly treated and should always be prevented. Psychiatric patients and inmates are the most affected population. A high index of suspicion is required to treat this rare condition, which may be preventable if there is adequate mental and medical therapy along with close monitoring and family support. We present the case of a 31-year-old psychiatric patient. After prompt treatment, two razor blades were surgically removed from her intestines. She fully recovered and is doing well on follow-up controls.

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An Unusual Foreign Body Ingestion in a Schizophrenic Patient: Case Report

The International Journal of Psychiatry in Medicine ◽

10.2190/7ae8-3av0-w3ua-tkv4 ◽

2005 ◽

Vol 35 (3) ◽

pp. 313-318 ◽

Cited By ~ 12

Author(s):

Benjamin Abraham ◽

Adekola O. Alao

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Paranoid Schizophrenia ◽

Auditory Hallucinations ◽

Foreign Body Ingestion ◽

Patient Case ◽

Unusual Foreign Body ◽

Treatment And Prevention ◽

Intentional Ingestion ◽

Extensive Coverage

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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Foreign Body Ingestion in Pediatrics: Distribution, Management and Complications

Medicina ◽

10.3390/medicina55100686 ◽

2019 ◽

Vol 55 (10) ◽

pp. 686 ◽

Cited By ~ 4

Author(s):

Khorana ◽

Tantivit ◽

Phiuphong ◽

Pattapong ◽

Siripan

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Foreign Body Ingestion ◽

Common Symptom ◽

Distribution Management ◽

Common Location ◽

Classification Of Diseases ◽

Icd 10 ◽

International Statistical Classification ◽

History Of

Background and Objectives: Foreign body (FB) ingestion is a common problem in children, causing serious complications. This study aimed to identify the distribution of types and locations of these foreign bodies and create Chiang Mai University (CMU) Guidelines. Materials and Methods: A retrospective descriptive study was conducted. All patients under 15 years old with foreign body ingestion (International Statistical Classification of Diseases and Related Health Problems; ICD-10 codes T18) treated in CMU Hospital from January 2006 to December 2017 were included. The data were analyzed using descriptive statistics. The guidelines were created, which paralleled the standard guidelines. Results: In total, 194 episodes of FB ingestion were recorded. These included 53.6% males and 46.4% females with a median age of 43.5 months. A history of foreign body ingestion complaints occurred in 77.8% of cases. Presentation was divided into asymptomatic (44.3%) and symptomatic (55.7%). The most common symptom was vomiting (23.2%). In the majority of cases, foreign bodies were located in the esophagus (37%). The most common type of foreign body was a coin (41.2%). Management included spontaneous passing (60.3%), endoscopy (35.6%), and others (3.1%). Complications before treatment were recorded in 9.3% of cases and after treatment in 2.1% of cases. Conclusions: Foreign body ingestion is common among children younger than four years old. Coins are the most common foreign body found, and the esophagus is the most common location. We recommend our created CMU Guidelines for management.

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