First Year Fellows Endoscopy Course ( August 6-7) | 2023-11-Foreign

11-Foreign_Body Management

Pdf Summary

This document summarizes the management of foreign bodies and food impactions in the GI tract. It discusses the timing and location of endoscopy, high-risk objects, choosing the right accessories, and airway protection. The document highlights that 1500 people die annually from ingesting foreign bodies, with the pediatric age group being at the highest risk. It states that most foreign bodies pass spontaneously, but 10-20% require endoscopy and 1% require surgery. Complications from foreign bodies include perforation, mediastinitis, lung abscess, fistula, and aspiration. Commonly ingested objects include coins, toys/magnets, crayons, ballpoint pen caps, batteries, meat, bones, and dentures.<br /><br />The document explains the symptoms and presentations of patients with foreign bodies, such as dysphagia, neck tenderness, odynophagia, hypersalivation, regurgitation, and abdominal pain. It also discusses the physical examination and radiologic imaging to determine the location of the object and potential complications.<br /><br />The document provides guidelines for the endoscopic removal of foreign bodies, emphasizing the need for prompt removal to prevent complications. It also discusses the precautions to take for patients with airway compromise. It lists the tools and accessories used for endoscopic removal, including grasping forceps, polypectomy snare, retrieval net, retrieval basket, foreign body hood, and overtube.<br /><br />Specific scenarios and considerations are presented for esophageal food bolus impaction, eosinophilic esophagitis, sharp and pointed foreign bodies, button batteries, and multiple magnets. Complications and potential risks associated with these objects are discussed.<br /><br />The document concludes by summarizing the key points, including the recognition of indications for urgent endoscopy, contraindications for endoscopic retrieval, and the importance of planning and airway protection during the procedure. It also emphasizes the need for recognizing eosinophilic esophagitis and being familiar with the available equipment.

Keywords

foreign bodies

endoscopy timing

high-risk objects

airway protection

complications

symptoms

endoscopic removal

pediatric age group

commonly ingested objects

eosinophilic esophagitis