Endoscopic foreign body removal in the upper gastrointestinal tract: risk factors predicting conversion to surgery

Abstract

Most of the foreign bodies in the UGIT were successfully removed by endoscopic techniques. However, surgical removal might need to be considered in patients with age >70 years, and those with foreign bodies in the upper esophagus, maximal diameter >30 mm, and impaction time >40 h, due to the possible high failure rate of endoscopic removal.

Fluoroscopy-Guided Endoscopic Removal of Foreign Bodies

“…Therefore, in such cases, emergency intervention with endoscopic or surgical removal of the foreign body is necessary [1,3]. A recent study by Lee et al [6] reported that the major complications of foreign bodies were laceration (9.5%), ulceration (6.8%), bleeding (3.4%), and perforation (2.1%). In that study, among those with foreign body-related perforation, ten patients received medical treatment, whereas the remaining four patients required surgical treatment [6].…”

“…A recent study by Lee et al [6] reported that the major complications of foreign bodies were laceration (9.5%), ulceration (6.8%), bleeding (3.4%), and perforation (2.1%). In that study, among those with foreign body-related perforation, ten patients received medical treatment, whereas the remaining four patients required surgical treatment [6]. In another study, Hong et al [7] reported that foreign body–mediated complications included perforation (1.5%), laceration (16%), infection (0.5%), and ulceration (5.7%).…”

Endoscopic extirpation of a fork after three days; Case report and review of the literature

“…In the literature there are studies detecting no correlations between the duration of the impaction and the risk of complications [6]. But most of the studies reported, in accordance with the guidelines, that the endoscopic interventions for the ingested foreign bodies had a low rate of success if the object was sharp or if the intervention was performed later than 12 hours, and the duration of impaction increased the risk as well [5,7]. In our case, no complications developed and it was possible to remove the object by endoscopy although the duration of impaction was 72 hours.…”

“…For example, trying to remove a foreign object by bolus ingestion of food may worsen the gastrointestinal trauma [8]. Therefore it should be recognized that pointed objects, long foreign bodies, and the presence of complications are important risk factors for further complications [7]. It is clear that a pointed object cannot be pulled out by directly holding its pointed or sharp ends otherwise it will lead to the injuries in the gastrointestinal system.…”

Ingestión accidental de prótesis dental, 2 panoramas en el manejo y evolución. Reporte de casos

“…Pero siempre hay que tener como primera opción terapéutica la cirugía abierta, en caso de presentar tiempo de evolución prolongado (mayor a 6 días sin su expulsión), así como datos de obstrucción, respuesta inflamatoria sistémica o dolor. Algunos factores de riesgo detectados para la conversión a cirugía abierta son: pacientes mayores de 70 años, localización superior en el esófago, tamaño grande del cuerpo extraño y mayor tiempo de evolución con el objeto 13 . Una sospecha diagnós-tica y tratamiento oportuno, sea por endoscopia o cirugía, así como un seguimiento apegado, pueden ser la diferencia en la evolución y desenlace de la ingesta de cuerpos extraños.…”