ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-based Learning (Day Two)

Pdf Summary

The document, titled "Ingested Foreign Bodies!" by Sumeet K. Tewani, MD, FASGE, provides a comprehensive overview of foreign body ingestion and its management. It offers insights into the epidemiology, evaluation, symptoms, imaging, and management of foreign body ingestion cases. Annually, there are approximately 100,000 cases in the US, with children being the most affected demographic, constituting 80% of these cases. The ingestion is usually accidental, with a significant recurrence rate, and most cases resolve spontaneously. However, a fraction requires endoscopic intervention, and even fewer need surgical procedures.<br /><br />The document addresses specific objects ingested by children and adults. In children aged 6 months to 6 years, the most common items include coins, toy parts, and batteries. In adults, food impaction, particularly from meats, is prevalent, often related to underlying esophageal conditions. Psychiatric disorders, developmental delays, and other factors like substance abuse can also contribute to ingestion cases in adults.<br /><br />Evaluation involves a detailed history and physical examination. Symptoms range from dysphagia and emesis to more severe signs like chest pain and abdominal discomfort. Imaging, primarily X-rays, helps confirm the presence and location of the foreign body, but CT scans are considered in cases with suspected complications.<br /><br />Management strategies emphasize ensuring airway safety and using various retrieval devices, such as forceps, snares, and nets, depending on the type and location of the ingested object. Emergency endoscopy may be necessary for complete obstructions. Specific management protocols are detailed for different types of objects, such as coins, batteries, magnets, and sharp pointed items.<br /><br />The document also discusses body packing, a practice involving the ingestion of drug packets, which requires careful management to avoid potentially fatal outcomes if packets rupture. Surgery is recommended for cases of failed progression or suspected packet rupture.

Asset Subtitle

Sumeet K. Tewani, MD, FASGE

Keywords

foreign body ingestion

epidemiology

endoscopic intervention

children ingestion

adult ingestion

imaging

management strategies

body packing

psychiatric disorders

airway safety