Approach to foreign bodies in the upper Gastrointestinal system

Year 2019, Volume: 11 Issue: 4, 504 - 508, 01.12.2019

Mustafa Şentürk , Halil Özer , Yusuf Yavuz

https://doi.org/10.21601/ortadogutipdergisi.545267

Abstract

Objective: The aim of this study is to reveal the clinical presentations and treatment approaches to the patients applied with foreign body ingestion and food residue accompanied by literature.
Materials and Methods: Patients who were admitted to the general surgery clinic of Ceylanpinar State Hospital between March 2018 and March 2019 with the suspicion of ingestion of foreign bodies in the upper gastrointestinal tract and food residue were evaluated retrospectively.
Findings: The mean age of our patients was 31.3 (min-max: 18-76). Endoscopy without sedation was performed to 3 patients (37.5%) due to the feeling of stuck. In 2 patients, the bone fragments detected in the esophagus were excised with the help of endoscopic forceps. One of the three endoscopic procedures have failed. Patient whose endoscopy was unsuccessful and five other patients were followed-up medically in order to let foreign bodies or food residues to leave the digestive tract spontaneously. None of the patients had esophageal disease or a known psychiatric disorder. The mean duration of admission to the hospital was 12.5 (min-max: 6-36) hours. Three patients (37.5%) had foreign body feeling and dysphagia. Four of the patients (50%) had foreign bodies and the rest of the patients had food residue. The localization of foreign bodies or food residues were detected as; stomach in 1 patient (12.5%), esophagus in 3 patients (37.5%) and intestines in other 4 patients (50%). None of the patients required surgical intervention.
Conclusion: In the early period, endoscopic procedures show a high success rate without complications in the treatment of foreign bodies in the upper gastrointestinal tract. However, it is an appropriate approach to wait for the spontaneous exit of the foreign body in cases that the foreign body have already passed the upper gastrointestinal system.

Keywords

endoscopy, foreign body, food residue

Üst Gastrointestinal sistemdeki yabancı cisimlere yaklaşım

Abstract

Amaç: Bu çalışma ile amacımız yabancı cisim yutulması ve gıda artığı ile başvuran hastalara kliniğimizin tedavi yaklaşımını ve klinik prezentasyonlarını literatür eşliğinde ortaya koymaktır.
Gereç ve Yöntem: Mart 2018 ve Mart 2019 tarihleri ​​arasında Ceylanpınar Devlet Hastanesi genel cerrahi kliniğine üst gastrointestinal sistem yolunda yabancı cisim yutulması ve gıda artığı şüphesi ile başvuran hastalar retrospektif olarak değerlendirildi
Bulgular: Hastalarımızın ortalama yaşı 31,3 (min-max: 18-76) idi. 3 hastaya (%37,5) takılma hissi nedeniyle sedasyonsuz endoskopi yapıldı. 2 hastada özofagusta tespit edilen kemik parçası endoskopik foreps yardımıyla eksize edildi. Üç endoskopik işlemden biri başarısızlıkla sonuçlandı. Endoskopisi başarısızlıkla sonuçlanan hasta ile birlikte 6 hasta yabancı cisim veya gıda artıklarının sindirim kanalını spontan terk etmesi için medikal takip edildi. Hastaların hiçbirinde özofageal hastalık veya bilinen bir psikiyatrik hastalık yoktu. Hastaneye ortalama başvuru süresi 12,5 (min-max:6-36) saat olarak tespit edildi. 3 hastada (%37,5) yabancı cisim algısı ve disfaji mevcuttu. Hastaların 4’ünde (%50) yabancı cisim, geri kalanında ise gıda artığı izlendi. İlk başvuruda yabancı cisim veya gıda artıklarının lokalizasyonu 1 hastada midede (%12,5), 3 hastada özofagusta (%37,5), diğer 4 hasta ise bağırsaklarda (%50) tespit edildi. Hiçbir hastada cerrahi müdahale gerektirecek bir durum gelişmedi.
Sonuç: Erken dönemde başvurular endoskopik prosedürlerin, üst GI kanaldaki yabancı cisimlerin tedavisinde komplikasyonlar olmadan yüksek bir başarı oranı göstermektedir. Ancak üst gastrointestinal sistemi geçmiş olan yabancı cisim vakalarında yabancı cismin sponta çıkışını beklemek uygun bir yaklaşımdır.

Keywords

endoskopi, yabancı cisim, gıda artığı

References

• Schwartz GF, Polsky HS. Ingested foreign bodies of the gastrointestinal tract. Am Surg 1976; 42: 236-238.
• Anderson KL, Dean AJ. Foreign bodies in the gastrointestinal tract and anorectal emergencies. Emerg Med Clin North Am 2011; 29: 369-400.
• Ginsberg GG. Management of ingested foreign objects and food bolus impactions. Gastrointest Endosc 1995; 41: 33-38.
• Cheng W, Tam PK. Foreign body ingestion in children: Experience with 1,265 cases. J Pediatr Surg 1999; 34: 1472-1476.
• 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: 319-323.
• Yuan F, Tang X, Gong W, Su L, Zhang Y. Endoscopic management of foreign bodies in the upper gastrointestinal tract: An analysis of 846 case in China. Experimental and therapeutic Medicine. 2018; 15(2): 1257-1262.
• Libânio D, Garrido M, Jácome F, Dinis-Ribeiro M, Pedroto I, Marcos-into R. Foreign body ingestion and food impaction in adults: Better to scope than to wait. United European Gastroenterology Journal, 2018, March 14; 205064061876580.
• ASGE Standards of Practice Committee; Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben Menachem T, Decker GA, Fanelli RD, Fisher LR, et al: Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011; 73: 1085-1091.
• Zhang S, Cui Y, Gong X, Gu F, Chen M and Zhong B: Endoscopic management of foreign bodies in the upper gastrointestinal tract in South China: A retrospective study of 561 cases. Dig Dis Sci 2010; 55: 1305-1312.
• 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; 64: 485-492.
• Vesna D, Tatjana A, Slobodan S, Slobodan N. Cardiac tamponade caused by migration of a swallowed sewing needle. Forensic Sci Int 2004; 139: 237-239. 18. McKechnie JC: Gastroscopic removal.
• Longstreth GF, Longstreth KJ, Yao JF. Esophageal food impaction: Epidemiology and therapy. A retrospective, observational study. Gastrointest Endosc 2001; 53: 193-198.
• Stack LB, Munter DW. Foreign bodies in the gastrointestinal tract. Emerg Med Clin North Am 1996; 14: 493-521.
• Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48: 489–496.
• Lyons MF II, Tsuchida AM. Foreign bodies of the gastrointestinal tract. Med Clin North Am 1993; 77: 1101-1114.
• Chiu YH, Hou SK, Chen SC, How CK, Lam C, Kao WF, Yen DH, Huang MS. Diagnosis and endoscopic management of upper gastrointestinal foreign bodies. Am J Med Sci 2012; 343: 192-195.
• Webb WA. Management of foreign bodies of the upper gastrointestinal tract: Update. Gastrointest Endosc 1995; 41: 39-51.