Foreign body ingestion and food impaction in adults: better to scope than to wait

• Type: Article in International Scientific Journal
• Date: 2018

Authors

Libanio, D (Author) FMUP; Garrido, M (Author) Other; Jacome, F (Author) Other; Mario Dinis Ribeiro (Author) FMUP; Pedroto, I (Author) ICBAS; Marcos Pinto, R (Author) Other

Journal

Title: United European Gastroenterology Journal

Vol. 6

Pages: 974-980

ISSN: 2050-6406

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 14 Citations

Scopus - 14 Citations

Other information

Authenticus ID: P-00P-GMD

DOI: 10.1177/2050640618765804

Abstract (EN): Background and objective: To assess clinical outcomes after foreign body ingestion and food impaction; to identify predictors of foreign body presence at the time of endoscopy. Methods: A prospective study including consecutive adult patients with foreign body ingestion or suspected food impaction between May 2014 and August 2016. Results: In total, 521 patients were included, 320 with foreign body ingestion and 201 with suspected food impaction. Food impaction patients were significantly older and more frequently had a history of oesophageal disease. The foreign body was encountered in the upper digestive tract in 43% of the patients with foreign body ingestion, and food impaction was confirmed in 87%. Older age (odds ratio (OR)(year) 1.04, 95% confidence interval (CI) 1.02-1.06) and early presentation (ORfirst (six) (hours) 4.41, 95% CI 2.24-8.66) were independent predictors of foreign body presence, while a history of psychiatric disease was an independent predictor of food impaction (OR 6.69, 95% CI 1.66 26.9). Successful endoscopic treatment was achieved in more than 90% of the cases, with adverse events occurring in fewer than 5%. Foreign body forceps was the preferred device in foreign body ingestion, while retrieval basket and mobilisation were preferred in food impaction. The need to use more than one instrument was significantly higher in food impaction. Conclusion: Foreign bodies are encountered at endoscopy in almost half of the cases. Older age and earlier presentation are independent predictors of its presence. Given the high proportion of patients with foreign body at endoscopy and the low risk of complications, endoscopic evaluation is probably justified in the majority of cases.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7