Analysis of Patients with Foreign Body Detected in Upper Endoscopy: Single Center Retrospective Study in East Black Sea Region

Abstract

Objective: Although foreign body ingestion can be seen at any age, it is more common in the pediatric population between the ages of six months and five years, that tends to recognize the objects by taking them into their mouths. We aimed to retrospectively investigate the patients with foreign bodies detected during upper gastrointestinal endoscopy.

Material and Methods: The patients with foreign bodies detected in upper gastrointestinal endoscopy between December 2009 and February 2014 in our clinic were evaluated retrospectively. Demographic data, complaints at admission, type and location of foreign bodies, treatment and endoscopic findings of the patients were recorded.

Results: Of the 44 patients included in the study, 19 were female and 25 were male. The mean age of the patients was 55.65 years (16-93). Five patients had no complaints, 11 had dysphagia, 2 had retrosternal pain, 7 had dysphagia and retrosternal pain, 3 had nausea and vomiting, 11 had epigastric pain, and 5 had gastrointestinal bleeding. Foreign bodies detected during endoscopy were; metal (pin, 1 Turkish lira, spoon handle, triple tooth bridge, tooth covering), food (meat, apricot kernel, olive kernel, plum kernel, garlic), 1 tooth brush, 1 blister package (drug) and bezoars in 14 patients. Emergency endoscopy was performed in 33 patients and foreign body was removed with foreign body forceps, snare, snare basket and holding forceps in 31 of these patients and in 2 of them, the olive seed that was impacted in the esophagus was pushed into the stomach.

Conclusion: Surgical intervention for foreign bodies in the gastrointestinal tract is usually not required. Foreign bodies can be disposed spontaneously in days or can be removed endoscopically. However, it should be kept in mind that surgical intervention may be required according to the type of foreign body, the place of attachment, the length of stay at the site and the patient's symptoms.

Keywords

• Endoscopy,foreign body,surgery

ÜST ENDOSKOPİDE YABANCI CİSİM SAPTANAN HASTALARIN ANALİZİ: DOĞU KARADENİZDE TEK MERKEZLİ RETROSPEKTİF ÇALIŞMA

Abstract

Amaç: Yabancı cisim yutulması, her yaşta görülebilmekle birlikte, çevresindeki cisimleri ağızlarına götürerek tanıma eğiliminde olan altı ay-beş yaş arasındaki pediatrik popülasyonda daha sık görülmektedir. Biz de kliniğimizde üst gastrointestinal endoskopi sırasında yabancı cisim saptanan hastaların retrospektif olarak incelenmesini amaçladık.

Gereç ve Yöntemler: Aralık 2009-Şubat 2014 tarihleri arasında, üst gastrointestinal endoskopide yabancı cisim saptanan hastalar retrospektif olarak değerlendirildi. Hastaların demografik bilgileri, başvuru anındaki şikayetleri, yabancı cismin tipi, yeri, uygulanan tedavi ve endoskopik bulgular kaydedildi.

Bulgular: Çalışmaya dahil edilen toplam 44 hastanın 19’u kadın, 25’i erkekti. Hastaların yaş ortalaması 55.65 yıl (16-93) idi. Hastaların 5’inde herhangi bir şikâyet yok iken, 11’inde disfaji, 2’sinde retrosternal ağrı, 7’sinde disfaji ve retrosternal ağrı, 3’ünde bulantı ve kusma, 11’inde epigastrik ağrı, 5’i de gastrointestinal kanama ile başvurdu. Endoskopi sırasında saptanan yabancı cisimler; metal (toplu iğne, 1 Türk lirası, kaşık sapı, 3’lü diş köprüsü, diş kaplaması), gıda (et, kayısı çekirdeği, zeytin çekirdeği, Malta eriği çekirdeği, sarımsak), 1 hastada diş fırçası, 1 hastada blister ambalaj (ilaç), 14 hastada bezoar şeklinde idi. Hastaların 33’üne acil endoskopi yapıldığı ve bu hastaların 31’inde yabancı cismin, yabancı cisim forsepsi, snare (fileli veya filesiz), basket kateter ile çıkarıldığı, 2’sinde de özofagusta impakte olan zeytin çekirdeğinin mideye itildiği görüldü.

Sonuç: Gastrointestinal sistemdeki yabancı cisimler genellikle cerrahi müdahale gerektirmez. Spontan olarak günler içinde atılabilir ya da endoskopik yolla çıkarılabilmektedir. Fakat yabancı cismin tipi, takıldığı yer, bulunduğu yerde kalış süresi ve hastanın semptomlara göre cerrahi müdahale gerekebileceği unutulmamalıdır.

Keywords

• cerrahi,endoskopi,yabancı cisim

References

1. 1. Ikenberry SO, Kue TL, Andersen MA, Appalaneni V, Banerjee S, Ben-Menachem T et al. ASGE Standards of Practice Committee. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011;73:1085-91.
2. 2. Dray X, Cattan P. Foreign bodies and caustic lesions. Best Pract Res Clin Gastroenterol. 2013;27(5):679-89.
3. 3. Pfau PR. Removal and management of esophageal foreign bodies. Tech Gastrointest Endosc. 2014;16(1):32-9.
4. 4. Sugawa C, Ono J, Taleb M, Lucas CE. Endoscopic management of foreign bodies in the upper gastrointestinal tract: A review. World J Gastrointest Endosc. 2014;6(10):475-81.
5. 5. Longstreth GF, Longstreth KJ, Yao JF. Esophageal food impaction: epidemiology and therapy. A retrospective, observational study. Gastrointest Endosc. 2001;53(2):193-8.
6. 6. 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;48(5):489-96.
7. 7. Abdullah BJJ, Teong LK, Mahadevan J, Jalaludin A. Dental prosthesis ingested and impacted in the esophagus and orolaryngopharynx. J Otolaryngol. 1998;27(4):190-4.
8. 8. Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc. 1995;41(1):39-51.

9. 9. Vizcarrondo FJ, Brady PG, Nord HJ. Foreign bodies of the upper gastrointestinal tract. Gastrointest Endosc. 1983;29(3):208-10.
10. 10. Connolly AA, Birchall M, Walsh-Waring GP, Moore-Gillon V. Ingested foreign bodies: patient guided localization is a useful clinical tool. Clin Otolaryngol. 1992;17(6):520-4.
11. 11. Eng JGH, Aks SE, Marcus C, Marcus C, Issleib S. False-negative abdominal CT scan in a cocaine body stuffer. Am J Emerg Med. 1999;17(7):702-4.
12. 12. Takada M, Kashiwagi R, Sakane M, Tabata F, Kuroda Y. 3D-CT diagnosis for ingested foreign bodies. Am J Emerg Med. 2000;18(2):192-3.
13. 13. Doraiswamy NV, Baig H, Hallam L. Metal detector and swallowed metal foreign bodies in children. J Accid Emerg Med. 1999;16(2):123-5.
14. 14. Ginsberg GG. Management of ingested foreign objects and food bolus impactions. Gastrointest Endosc. 1995;41(1):33-8.
15. 15. Ambe P, Weber SA, Schauer M, Knoefel WT. Swallowed foreign bodies in adults. Dtsch Arztebl Int. 2012;109(50):869-75.
16. 16. Loh KS, Tan LK, Smith JD, Yeoh KH, Dong F. Complications of foreign bodies in the esophagus. Otolaryngol Head Neck Surg. 2000;123(5):613-6.
17. 17. 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;43(4):226-33.
18. 18. Carp L. Foreign bodies in the intestine. Ann Surg. 1927;85(4):575-91.
19. 19. Hachimi-Idrissi S, Come L, Vandenpias Y. Management of ingested foreign bodies in childhood: our experience and review of the literature. Eur J Emerg Med. 1998;5(3):319-23.