Unique Pattern of True Foreign-Body Ingestion in the Valley of Kashmir; Sharp Foreign Bodies Outnumbering the Blunt Ones

Abstract

Background and Aims: Foreign-body ingestion is a common phenomenon, especially in children. In normal adults, foreign-body ingestion is usually accidental and mostly ingestion occurs with food and impaction is a result of structural abnormalities of the upper gastrointestinal tract (UGIT). However, accidental ingestion of nonfood products is unusual; especially ingestion of pins (scarf or safety pins) and needles is unknown. We come across ingestion of these unusual/sharp foreign bodies routinely from the past few years. The aim of this study was to observe, over a period of 1 year, the spectrum of nonfood or true foreign-body ingestion in our community and to see the impact of an early endoscopy on outcome or retrieval of the ingested objects. Materials and Methods: In a prospective observational study, we studied the profile of foreign-body ingestion in normal individuals of all ages and both sexes, excluding the individuals with any structural abnormalities of the gut and the people with psychiatric ailment. Results: Of total 51 patients with foreign-body ingestion, 42 (82%) were 20 or <20 years of age with females constituting 86.3% of the total and males constituting only 13.7%. Foreign bodies ingested included 38 pins (74.5%), seven coins (13.7%), four needles (7.8%), and one denture and a nail (2%) each. Overall 26 (51%) foreign bodies were seen in UGIT (within reach of retrieval) at the time of endoscopy and all of them were retrieved. Nineteen (37.3%) patients reported within 6 h of ingestion, and majority of them (16 = 84.2%) had foreign bodies within UGIT and all of them were removed. Those patients (n = 32; 62.7%) who reported beyond 6 h, only 10 (31.25%) had foreign bodies in UGIT as a result of which the success rate of removal in these patients was only 32%. Conclusion: Most of our patients were young females and the common foreign bodies ingested were sharp including scarf pins followed by coins and needles. The success rate of retrieval was high in those who reported within 6 h of ingestion of foreign body. The rate of retrieval was 100% if foreign body was found on esophagogastroduodenoscopy. Hence, we recommend an early endoscopy in these patients and some alternative to use of scarf pins. AbstractThis is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

An extraluminal migration of a gastrointestinal foreign body to the anterior abdominal wall: A rare case report

“…Especially, an ingestion of sharp metallic objects is a clinical experience that occurs commonly. Nonetheless, an ingestion of insulated electrical wire is extremely rare, and probably this case report would be the first one globally [ 1 , 7 ]. Furthermore, most of the patients who swallowed foreign bodies some time ago usually fail to recall them during patient evaluation unless they were swallowed consciously, which will pose difficulty in making a diagnosis.…”

“…Small and blunt objects tend to pass through the gastrointestinal tract without complications in most cases, whereas sharp and elongated foreign bodies are more likely to get held up in the bowel and result in their penetration and perforation. In addition to foreign body characteristics, the risk of impaction can increase in the presence of structural and functional abnormalities of the GI tract like diverticulum, webs, rings, strictures, achalasia, tumours, duodenal ulcer sequelae, hernia, and postgastrectomy status [ 3 , 7 , 10 ]. A foreign body causes a bowel perforation frequently at the point of acute angulation and narrowing, even though it can cause perforation anywhere.…”