First Year Fellows Endoscopy Course (August 4-5) | 2023-11-Foreign

11-Foreign_Body Management

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This document provides information on the management of foreign bodies and food impactions in the gastrointestinal tract. It covers topics such as the timing and location of endoscopy, high-risk objects, choosing the right accessories, and airway protection. Ingested foreign bodies can lead to complications such as perforation, mediastinitis, lung abscess, fistula, and aspiration. The most common objects ingested by children are coins, toys/magnets, crayons, ballpoint pen caps, and batteries, while in adults, food impactions, dentures, and sharp objects are more commonly encountered. Patients may present with symptoms such as dysphagia, neck tenderness, odynophagia, hypersalivation, regurgitation, and abdominal pain. Radiologic imaging can help determine the location of the object and assess for complications. Endoscopic removal of foreign bodies is indicated within 12-24 hours to prevent complications such as airway compromise, perforation, and fistula. Sharp and pointed foreign bodies, button batteries, and multiple magnets require urgent endoscopy. Eosinophilic esophagitis, a common cause of food impaction, should be recognized before removing a foreign body. Sharp and pointed foreign bodies should be removed before they pass through the stomach, and button batteries require immediate attention due to the risk of injury and complications. Multiple magnets may require endoscopic or surgical removal depending on the location. It is important to recognize contraindications for endoscopic retrieval and to protect the airway during the procedure. Planning the strategy and being familiar with available equipment are also key factors in successful management.

Keywords

foreign bodies

food impactions

gastrointestinal tract

endoscopy

high-risk objects

accessories

airway protection

complications

children

adults