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What is the role of an endoscopist in foreign body management in the upper gastrointestinal tract in adults?

Year 2024, Volume: 38 Issue: 3, 215 - 223, 27.12.2024

Süleyman Dolu

https://doi.org/10.18614/deutip.1467883

Abstract

Background: Foreign body ingestion in the upper gastrointestinal tract is considered an emergency worldwide. The aim of this paper is to report our experience and outcomes in the endoscopic management of foreign bodies in the upper gastrointestinal tract.
Methods: This retrospective study was conducted on adult patients (aged >18 years) who received endoscopic management of foreign bodies at xxx between december 2022 and december 2023.
Results: A total of 56 patients (male/female: 27/29; median age: 56 years) were included. Chicken bones were the most common ingested foreign bodies (n = 32; 57.1%), and the upper esophagus was the most common lodgment site (n = 28; 50%). The detection rate of ingested foreign bodies in the upper gastrointestinal tract tract through plain radiography was 66% (2/3) and computed tomography was 82% (38/46). The average "door-to-scope" was 2.4±1.2 hours. The complication rate was low. Endoscopic treatment was successful in 50 patients (89.3%), and surgical treatment was required in 5 patients (8.9%). There was no mortality associated with the endoscopic procedures of removing foreign bodies.
Conclusion: Endoscopic management is a safe and effective procedure for ingested foreign bodies when performed by experienced hands. The endoscopic technique has the advantages of high success rates, a lower incidence of minor complications, and a decreased need for surgery.

Keywords

Endoscopic management Foreign bodies Gastrointestinal tract

Supporting Institution

none

Thanks

teşekkürler

References

  • 1. Lee CY, Kao BZ, Wu CS, Chen MY, Chien HY, Wu LW, et al. Retrospective analysis of endoscopic management of foreign bodies in the upper gastrointestinal tract of adults. J Chin Med Assoc. 2019 Feb;82(2):105-109. doi: 10.1097/JCMA.0000000000000010. PMID: 30839499.
  • 2. Nassar E, Yacoub R, Raad D, Hallman J, Novak J. Foreign Body Endoscopy Experience of a University Based Hospital. Gastroenterology Res. 2013 Feb;6(1):4-9. doi: 10.4021/gr517w. Epub 2013 Mar 9. PMID: 27785219; PMCID: PMC5051113.
  • 3. Wu WT, Chiu CT, Kuo CJ, Lin CJ, Chu YY, Tsou YK, et al. Endoscopic management of suspected esophageal foreign body in adults. Dis Esophagus. 2011 Apr;24(3):131-7. doi: 10.1111/j.1442-2050.2010.01116.x. Epub 2010 Oct 13. PMID: 20946132.
  • 4. ASGE Standards of Practice Committee; Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T,et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011 Jun;73(6):1085-91. doi: 10.1016/j.gie.2010.11.010. PMID: 21628009.
  • 5. Palta R, Sahota A, Bemarki A, Salama P, Simpson N, Laine L. Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion. Gastrointest Endosc. 2009 Mar;69(3 Pt 1):426-33. doi: 10.1016/j.gie.2008.05.072. Epub 2008 Nov 18. PMID: 19019363.
  • 6. Geraci G, Sciume' C, Di Carlo G, Picciurro A, Modica G. Retrospective analysis of management of ingested foreign bodies and food impactions in emergency endoscopic setting in adults. BMC Emerg Med. 2016 Nov 4;16(1):42. doi: 10.1186/s12873-016-0104-3. PMID: 27809769; PMCID: PMC5095952.
  • 7. Simic MA, Budakov BM. Fatal upper esophageal hemorrhage caused by a previously ingested chicken bone: case report. Am J Forensic Med Pathol. 1998 Jun;19(2):166-8. doi: 10.1097/00000433-199806000-00013. PMID: 9662114.
  • 8. McKechnie JC. Gastroscopic removal of a phytobezoar. Gastroenterology. 1972 May;62(5):1047-51. PMID: 5029071.
  • 9. Limpias Kamiya KJ, Hosoe N, Takabayashi K, Hayashi Y, Sun X, Miyanaga R, et al. Endoscopic removal of foreign bodies: A retrospective study in Japan. World J Gastrointest Endosc. 2020 Jan 16;12(1):33-41. doi: 10.4253/wjge.v12.i1.33. PMID: 31942232; PMCID: PMC6939123.
  • 10. Yao CC, Wu IT, Lu LS, Lin SC, Liang CM, Kuo YH, et al. Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults. Biomed Res Int. 2015;2015:658602. doi: 10.1155/2015/658602. Epub 2015 Jul 15. PMID: 26258140; PMCID: PMC4518178.
  • 11. Chiu YH, Hou SK, Chen SC, How CK, Lam C, Kao WF, et al. Diagnosis and endoscopic management of upper gastrointestinal foreign bodies. Am J Med Sci. 2012 Mar;343(3):192-5. doi: 10.1097/MAJ.0b013e3182263035. PMID: 21804366.
  • 12. Wang X, Zhao J, Jiao Y, Wang X, Jiang D. Upper gastrointestinal foreign bodies in adults: A systematic review. Am J Emerg Med. 2021 Dec;50:136-141. doi: 10.1016/j.ajem.2021.07.048. Epub 2021 Jul 29. PMID: 34365062.
  • 13. Saltiel J, Molinsky R, Lebwohl B. Predictors of Outcomes in Endoscopies for Foreign Body Ingestion: A Cross-Sectional Study. Dig Dis Sci. 2020 Sep;65(9):2637-2643. doi: 10.1007/s10620-019-06033-3. Epub 2020 Jan 6. PMID: 31907772.
  • 14. Pfau, Patrick R. "Removal and management of esophageal foreign bodies." Techniques in Gastrointestinal Endoscopy 16.1 (2014): 32-39.
  • 15. Birk M, Bauerfeind P, Deprez PH, Häfner M, Hartmann D, Hassan C, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016 May;48(5):489-96. doi: 10.1055/s-0042-100456. Epub 2016 Feb 10. PMID: 26862844.
  • 16. Loh KS, Tan LK, Smith JD, Yeoh KH, Dong F. Complications of foreign bodies in the esophagus. Otolaryngol Head Neck Surg. 2000 Nov;123(5):613-6. doi: 10.1067/mhn.2000.110616. PMID: 11077351.
  • 17. Wu WT, Chiu CT, Kuo CJ, Lin CJ, Chu YY, Tsou YK, et al. Endoscopic management of suspected esophageal foreign body in adults. Dis Esophagus. 2011 Apr;24(3):131-7. doi: 10.1111/j.1442-2050.2010.01116.x. Epub 2010 Oct 13. PMID: 20946132.
  • 18. Hong KH, Kim YJ, Kim JH, Chun SW, Kim HM, Cho JH. Risk factors for complications associated with upper gastrointestinal foreign bodies. World J Gastroenterol. 2015 Jul 14;21(26):8125-31. doi: 10.3748/wjg.v21.i26.8125. PMID: 26185385; PMCID: PMC4499356.
  • 19. Park JH, Park CH, Park JH, Lee SJ, Lee WS, Joo YE, et al. [Review of 209 cases of foreign bodies in the upper gastrointestinal tract and clinical factors for successful endoscopic removal]. Korean J Gastroenterol. 2004 Apr;43(4):226-33. Korean. PMID: 15100486.
  • 20. Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc. 1995 Jan;41(1):39-51. doi: 10.1016/s0016-5107(95)70274-1. PMID: 7698623.
  • 21. Li ZS, Sun ZX, Zou DW, Xu GM, Wu RP, Liao Z. Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China. Gastrointest Endosc. 2006 Oct;64(4):485-92. doi: 10.1016/j.gie.2006.01.059. Epub 2006 Aug 22. PMID: 16996336.
  • 22. Zhang, S., Cui, Y., Gong, X., Gu, F., Chen, M., & Zhong, B. (2010). Endoscopic management of foreign bodies in the upper gastrointestinal tract in South China: a retrospective study of 561 cases. Digestive diseases and sciences, 55, 1305-1312.
  • 23. Lin HH, Lee SC, Chu HC, Chang WK, Chao YC, Hsieh TY. Emergency endoscopic management of dietary foreign bodies in the esophagus. Am J Emerg Med. 2007 Jul;25(6):662-5. doi: 10.1016/j.ajem.2006.12.012. PMID: 17606092.

What is the role of an endoscopist in foreign body management in the upper gastrointestinal tract in adults?

Year 2024, Volume: 38 Issue: 3, 215 - 223, 27.12.2024

Süleyman Dolu

https://doi.org/10.18614/deutip.1467883

Abstract

Background: Foreign body ingestion in the upper gastrointestinal tract is considered an emergency worldwide. The aim of this paper is to report our experience and outcomes in the endoscopic management of foreign bodies in the upper gastrointestinal tract.
Methods: This retrospective study was conducted on adult patients (aged >18 years) who received endoscopic management of foreign bodies at xxx between december 2022 and december 2023.
Results: A total of 56 patients (male/female: 27/29; median age: 56 years) were included. Chicken bones were the most common ingested foreign bodies (n = 32; 57.1%), and the upper esophagus was the most common lodgment site (n = 28; 50%). The detection rate of ingested foreign bodies in the upper gastrointestinal tract tract through plain radiography was 66% (2/3) and computed tomography was 82% (38/46). The average "door-to-scope" was 2.4±1.2 hours. The complication rate was low. Endoscopic treatment was successful in 50 patients (89.3%), and surgical treatment was required in 5 patients (8.9%). There was no mortality associated with the endoscopic procedures of removing foreign bodies.
Conclusion: Endoscopic management is a safe and effective procedure for ingested foreign bodies when performed by experienced hands. The endoscopic technique has the advantages of high success rates, a lower incidence of minor complications, and a decreased need for surgery.

Keywords

Endoscopic management Foreign bodies Gastrointestinal tract

References

  • 1. Lee CY, Kao BZ, Wu CS, Chen MY, Chien HY, Wu LW, et al. Retrospective analysis of endoscopic management of foreign bodies in the upper gastrointestinal tract of adults. J Chin Med Assoc. 2019 Feb;82(2):105-109. doi: 10.1097/JCMA.0000000000000010. PMID: 30839499.
  • 2. Nassar E, Yacoub R, Raad D, Hallman J, Novak J. Foreign Body Endoscopy Experience of a University Based Hospital. Gastroenterology Res. 2013 Feb;6(1):4-9. doi: 10.4021/gr517w. Epub 2013 Mar 9. PMID: 27785219; PMCID: PMC5051113.
  • 3. Wu WT, Chiu CT, Kuo CJ, Lin CJ, Chu YY, Tsou YK, et al. Endoscopic management of suspected esophageal foreign body in adults. Dis Esophagus. 2011 Apr;24(3):131-7. doi: 10.1111/j.1442-2050.2010.01116.x. Epub 2010 Oct 13. PMID: 20946132.
  • 4. ASGE Standards of Practice Committee; Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T,et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011 Jun;73(6):1085-91. doi: 10.1016/j.gie.2010.11.010. PMID: 21628009.
  • 5. Palta R, Sahota A, Bemarki A, Salama P, Simpson N, Laine L. Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion. Gastrointest Endosc. 2009 Mar;69(3 Pt 1):426-33. doi: 10.1016/j.gie.2008.05.072. Epub 2008 Nov 18. PMID: 19019363.
  • 6. Geraci G, Sciume' C, Di Carlo G, Picciurro A, Modica G. Retrospective analysis of management of ingested foreign bodies and food impactions in emergency endoscopic setting in adults. BMC Emerg Med. 2016 Nov 4;16(1):42. doi: 10.1186/s12873-016-0104-3. PMID: 27809769; PMCID: PMC5095952.
  • 7. Simic MA, Budakov BM. Fatal upper esophageal hemorrhage caused by a previously ingested chicken bone: case report. Am J Forensic Med Pathol. 1998 Jun;19(2):166-8. doi: 10.1097/00000433-199806000-00013. PMID: 9662114.
  • 8. McKechnie JC. Gastroscopic removal of a phytobezoar. Gastroenterology. 1972 May;62(5):1047-51. PMID: 5029071.
  • 9. Limpias Kamiya KJ, Hosoe N, Takabayashi K, Hayashi Y, Sun X, Miyanaga R, et al. Endoscopic removal of foreign bodies: A retrospective study in Japan. World J Gastrointest Endosc. 2020 Jan 16;12(1):33-41. doi: 10.4253/wjge.v12.i1.33. PMID: 31942232; PMCID: PMC6939123.
  • 10. Yao CC, Wu IT, Lu LS, Lin SC, Liang CM, Kuo YH, et al. Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract of Adults. Biomed Res Int. 2015;2015:658602. doi: 10.1155/2015/658602. Epub 2015 Jul 15. PMID: 26258140; PMCID: PMC4518178.
  • 11. Chiu YH, Hou SK, Chen SC, How CK, Lam C, Kao WF, et al. Diagnosis and endoscopic management of upper gastrointestinal foreign bodies. Am J Med Sci. 2012 Mar;343(3):192-5. doi: 10.1097/MAJ.0b013e3182263035. PMID: 21804366.
  • 12. Wang X, Zhao J, Jiao Y, Wang X, Jiang D. Upper gastrointestinal foreign bodies in adults: A systematic review. Am J Emerg Med. 2021 Dec;50:136-141. doi: 10.1016/j.ajem.2021.07.048. Epub 2021 Jul 29. PMID: 34365062.
  • 13. Saltiel J, Molinsky R, Lebwohl B. Predictors of Outcomes in Endoscopies for Foreign Body Ingestion: A Cross-Sectional Study. Dig Dis Sci. 2020 Sep;65(9):2637-2643. doi: 10.1007/s10620-019-06033-3. Epub 2020 Jan 6. PMID: 31907772.
  • 14. Pfau, Patrick R. "Removal and management of esophageal foreign bodies." Techniques in Gastrointestinal Endoscopy 16.1 (2014): 32-39.
  • 15. Birk M, Bauerfeind P, Deprez PH, Häfner M, Hartmann D, Hassan C, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy. 2016 May;48(5):489-96. doi: 10.1055/s-0042-100456. Epub 2016 Feb 10. PMID: 26862844.
  • 16. Loh KS, Tan LK, Smith JD, Yeoh KH, Dong F. Complications of foreign bodies in the esophagus. Otolaryngol Head Neck Surg. 2000 Nov;123(5):613-6. doi: 10.1067/mhn.2000.110616. PMID: 11077351.
  • 17. Wu WT, Chiu CT, Kuo CJ, Lin CJ, Chu YY, Tsou YK, et al. Endoscopic management of suspected esophageal foreign body in adults. Dis Esophagus. 2011 Apr;24(3):131-7. doi: 10.1111/j.1442-2050.2010.01116.x. Epub 2010 Oct 13. PMID: 20946132.
  • 18. Hong KH, Kim YJ, Kim JH, Chun SW, Kim HM, Cho JH. Risk factors for complications associated with upper gastrointestinal foreign bodies. World J Gastroenterol. 2015 Jul 14;21(26):8125-31. doi: 10.3748/wjg.v21.i26.8125. PMID: 26185385; PMCID: PMC4499356.
  • 19. Park JH, Park CH, Park JH, Lee SJ, Lee WS, Joo YE, et al. [Review of 209 cases of foreign bodies in the upper gastrointestinal tract and clinical factors for successful endoscopic removal]. Korean J Gastroenterol. 2004 Apr;43(4):226-33. Korean. PMID: 15100486.
  • 20. Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc. 1995 Jan;41(1):39-51. doi: 10.1016/s0016-5107(95)70274-1. PMID: 7698623.
  • 21. Li ZS, Sun ZX, Zou DW, Xu GM, Wu RP, Liao Z. Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China. Gastrointest Endosc. 2006 Oct;64(4):485-92. doi: 10.1016/j.gie.2006.01.059. Epub 2006 Aug 22. PMID: 16996336.
  • 22. Zhang, S., Cui, Y., Gong, X., Gu, F., Chen, M., & Zhong, B. (2010). Endoscopic management of foreign bodies in the upper gastrointestinal tract in South China: a retrospective study of 561 cases. Digestive diseases and sciences, 55, 1305-1312.
  • 23. Lin HH, Lee SC, Chu HC, Chang WK, Chao YC, Hsieh TY. Emergency endoscopic management of dietary foreign bodies in the esophagus. Am J Emerg Med. 2007 Jul;25(6):662-5. doi: 10.1016/j.ajem.2006.12.012. PMID: 17606092.
There are 23 citations in total.

Details

Primary Language English
Subjects Gastroenterology and Hepatology
Journal Section Research Articles
Authors

Süleyman Dolu 0000-0002-7496-9493

Publication Date December 27, 2024
Submission Date April 13, 2024
Acceptance Date October 23, 2024
Published in Issue Year 2024 Volume: 38 Issue: 3

Cite

Vancouver Dolu S. What is the role of an endoscopist in foreign body management in the upper gastrointestinal tract in adults?. DEU Tıp Derg. 2024;38(3):215-23.
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