Foreign body ingestion: Management of 167 cases

Jl, Barros; Caballero, Aránzazu; Rueda, JC; Jm, Monturiol

doi:10.1007/bf01665320

Cited by 61 publications

(25 citation statements)

References 19 publications

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“…1,2,[6][7][8] These results are similar to the results of this study. The number of IFB patients at preschool age, i.e., between one and seven years old, was 56, which was 63.6% of the total study group.…”

Section: Discussionsupporting

confidence: 91%

Clinical Analysis and Proper Management of the Patients Visited ER Due to Ingested Foreign Body: Single Center Experience

Park

Choi

et al. 2014

J Minim Invasive Surg

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Purpose:The conventional treatm ent for ingested foreign bodies (IFB) is rem oval, w hich is successful in m ost cases. How ever, it can be associated w ith severe com plications, such as gastrointestinal tract perforation, and require em ergency surgery. The aim of this study is to analyze clinical data relating to IFB and to develop a proper m anagem ent plan to reduce the incidence of severe com plications.Methods: Betw een Septem ber 2001 and Septem ber 2009, 117 patients visited the em ergency room com plaining of IFB. Am ong these patients, 29 w ere diagnosed w ith bezoar and were excluded from the study. Medical data for the rem aining 88 patients w as review ed retrospectively. For statistical analysis, the foreign bodies (FB) w ere classified into three subgroups according to their shape (round, sharp, and am orphous).Results: The m edian age of patients w ith IFB w as seven years, and the m ale-to-fem ale ratio was 1.3:1. Many of these patients w ere preschool children under the age of seven w ho had accidentally sw allow ed FB (56 cases, 63.6% ). The m ost com m on sym ptom presented am ong the patients was FB sensation (18 cases, 21% ). The results of subgroup analysis show ed no significant relation betw een the shape of the FB and the treatm ent m odality. Spontaneous passage w as observed in 21 cases (23.9% ). O therw ise, endoscopic rem oval was perform ed successfully in 61.4% of cases, and 13 patients required em ergency operations (14.8% ). Conclusion:Early diagnosis and a prom pt approach are significant in the successful treatm ent of IFB. Endoscopic or surgical procedures are som etim es required, particularly in cases w here com plications are suspected.

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Section: Discussionsupporting

confidence: 91%

Clinical Analysis and Proper Management of the Patients Visited ER Due to Ingested Foreign Body: Single Center Experience

Park

Choi

et al. 2014

J Minim Invasive Surg

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“…In some cases, these sharp foreign bodies can perforate the walls of stomach or duodenum and reach the liver. Foreign bodies reaching pancreas and liver parenchyma can cause abscess, pseudoaneurysm, pancreatitis, and high-mortality-risk complications (1,4,5).…”

Section: Discussionmentioning

confidence: 99%

“…Most of the ingested foreign bodies are excreted spontaneously (1). These foreign bodies may reach pancreas and liver in 1% of patients, through penetration of small intestine or stomach wall (1,2).…”

Section: Introductionmentioning

confidence: 99%

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Foreign body: A sewing needle migrating from the gastrointestinal tract to pancreas

et al. 2018

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Of all ingested foreign bodies, 2.4% comprise of sewing needles. Through perforation of gastrointestinal tract, which occurs in 1% of cases, they can migrate into the liver and pancreas. Foreign bodies in pancreas should be considered in the differential diagnosis of chronic abdominal pain. Computed tomography scans provide valuable information for the localization of the lesion, which guide the surgeon during the operation. Secondary to foreign bodies that migrate to the pancreas, complications with high mortality such as pancreatitis, pseudoaneurysm, and pancreas abscess can be seen. Thus, for this patient group, diagnostic laparoscopy is recommended, considering its advantages of decreased postoperative pain, decreased wound infection, and faster recovery time. Here we present a case of a 23-year-old female patient, from whom an ingested needle that migrated from the back wall of the stomach to the pancreas was extracted by laparoscopic surgery. Keywords: Sewing needle, pancreas, laparoscopy INTRODUCTIONOut of all the ingested foreign bodies, 43.7% are organic, 56.3% are inorganic, and 2.4% are sewing needles. Most of the ingested foreign bodies are excreted spontaneously (1). These foreign bodies may reach pancreas and liver in 1% of patients, through penetration of small intestine or stomach wall (1, 2). Foreign bodies in pancreas might cause serious complications such as pancreatitis, pancreatic abscess, and pseudoaneurysm. These should be removed either endoscopically or surgically (1, 3, 4). In few cases, foreign bodies can also be removed using open surgical techniques (2, 5). However, the suggested technique is the laparoscopic approach before open surgery (3, 6, 7). Here we report the case of a 23-year-old female patient, who presented with epigastric pain and a sewing needle was removed laparoscopically from her pancreas parenchyma. CASE PRESENTATIONA 23-year-old female patient presented with epigastric pain and retrosternal burns that continued intermittently for seven years. She had used proton pump inhibitors (PPI) and as her symptoms did not resolve, she presented to the hospital. In her physical examination, there was minimal tenderness and discomfort in the epigastric area without rebound sign or defense. Laboratory blood tests including her hemogram, biochemical markers, liver function tests, kidney function tests, and amylase levels were within normal limits. Her standing abdominal x-ray was also normal ( Figure 1a). During gastroscopy, no sign of any pathology related to a foreign body was observed. We performed a barium follow-through x-ray with an initial diagnosis of gastroesophageal reflux disease, and in this test, we observed a foreign body in the epigastric area (Figure 1b). When patient's medical history was questioned again, it was found that she had accidentally swallowed a sewing needle seven years ago. She underwent computed tomography screening and we saw that a foreign body was present starting from the posterior side of the stomach reaching head and body of the pancreas. (Fig...

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“…3 Sin embargo en adultos la ingesta accidental ocurre fundamentalmente en pacientes psiquiátricos o reclusos …”

Section: Introduccionunclassified

Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados

Trostchansky¹,

Masaferro²

2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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OEl 80-90% de los cuerpos extraños ingeridos voluntaria o accidentalmente se evacuan espontáneamente, sin embargo se requiere de una endoscopia terapéutica en un 10-20% de los casos y de cirugía en menos del 1% de los mismos.Objetivo: Analizar las características de los pacientes asistidos por ingesta de cuerpo extraño en el Departamento de Emergencia del Hospital Maciel y llegar al diseño de guías de actuación en el contexto de un equipo multidisciplinario.Resultados: Nuestra serie constó de 31 consultas por ingesta de cuerpo extraño. El 52% provenía de instituciones psiquiátricas y el 42% eran reclusos, un caso no pertenecía a ninguna de las 2 categorías. El 27,5% de las consulta se habían producido en las primeras 24hs desde la ingesta, el 24% de las ingestas se habían producido con más de una semana desde la ingesta y el resto oscilaba entra ambos tiempos evolutivos En cuanto a la conducta, en 12 casos se otorgó el alta sin mediar conducta activa endoscópica y/o quirúrgica. Se realizó una FGC en el 64% de los casos en los cuales se constató radiológicamente la ingesta de un cuerpo extraño, siendo efectivamente terapéuticas para la extracción de objetos a nivel gastroduodenal en el 67% de las mismas. De las 28 consultas por ingesta de CE 6 pacientes (21%) fueron operados. En 5 de ellos por falla de la extracción endoscópica, el restante se presentó como una peritonitis aguda. La ingesta de CE representa una patología de consulta frecuente en el Departamento de Emergencia. El manejo del mismo se realiza mediante un abordaje multidisciplinario que en el caso de nuestra serie mostró porcentajes de extracción endoscópica efectiva cercana al 70% comparable con otras series internacionales. El análisis de las características de la población analizada y el análisis de la evidencia científica publicada nos permite plantear un protocolo de actuación. Palavras Source of support: Nil Conflict of interest: None ABSTRACTAbout 80 to 90% of foreign bodies ingested voluntarily or accidentally are spontaneously ejected; however, a therapeutic endoscopy is required in 10 to 20% of cases and surgery in less than 1% of them.Objective: To analyze the characteristics of assisted patients due to foreign body ingestion in the Department of Emergency of Maciel Hospital and the design of protocols of action in the context of a multidisciplinary team. Results:Our series had 31 patients who came for consultation because of foreign body ingestion; 52% came from psychiatric care institutions, 42% were prisoners of state prison, and one case did not belong to any of the previous categories. About 27.5% of consultations occurred within the first 24 hours after ingestion, 24% of consultations in the Department of Emergency occurred after more than 1 week from ingestion, and the rest oscillated between both evolutionary times. Regarding the therapeutic behavior performed, in 12 cases it was decided to discharge the patient without active endoscopic conduct or surgery. A FGC was performed in 64% of cases in which the intake of the for...

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Foreign body ingestion: Management of 167 cases

Cited by 61 publications

References 19 publications

Clinical Analysis and Proper Management of the Patients Visited ER Due to Ingested Foreign Body: Single Center Experience

Clinical Analysis and Proper Management of the Patients Visited ER Due to Ingested Foreign Body: Single Center Experience

Foreign body: A sewing needle migrating from the gastrointestinal tract to pancreas

Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados

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