Foreign Bodies and Bowel Obstructions

Abstract

Foreign body ingestion most commonly occurs in the pediatric population, with approximately 80–90% of objects passing spontaneously in individuals who are evaluated by medical professionals. Objects may be lodged in a variety of anatomic locations. Only about 10% of foreign bodies progress past the stomach. Of the 10–20% of objects that fail to pass, less than 1% requires surgical intervention. Small bowel obstructions are a rare presentation of foreign body ingestions. There are case reports, guidelines, and retrospective reviews in the literature regarding the management of ingested foreign bodies. In patients who do not have spontaneous passage of foreign bodies, endoscopic and surgical techniques have been utilized for successful retrieval. The timing and indication for endoscopic intervention is dependent upon several factors, including the type and location of the foreign body and is also contingent upon patient symptoms. Numerous case reports and studies describe the successful endoscopic removal of foreign bodies in the upper and lower gastrointestinal tract. Although the type and location of an ingested object is critical for determining the success of endoscopic intervention, the patient’s clinical exam and stability is also an aspect to consider when deciding on management of bowel obstructions caused by foreign bodies.

Endoscopic esophageal foreign body removal among children at Lubaga Hospital, Kampala, Uganda

“…Symptoms of foreign body impaction include dysphagia, odynophagia, sensation of objects stuck in the throat, drooling, vomiting 1,3,4 . Intervention for ingested foreign bodies should be timely as there is potential to cause respiratory complications, intestinal obstruction, esophageal erosions and perforation 5 . Upper GI endoscopy is both a diagnostic and interventional module in management of FBs.…”