First Year Fellows Endoscopy Course (July 30-31) | 2023-11-Foreign

11-Foreign_Body Management

Pdf Summary

This document discusses the management of foreign bodies and food impactions in the gastrointestinal (GI) tract. It covers topics such as the timing of endoscopy, the anatomical location of the foreign body, high-risk objects, choosing the appropriate accessories, and airway protection. It highlights the risks associated with foreign bodies in the GI tract, such as esophageal perforation, mediastinitis, lung abscess, fistula, and aspiration. It emphasizes the importance of considering the possibility of more than one foreign body. <br /><br />The document provides a list of common objects that are frequently ingested by children and adults. It also includes the patient presentation, including symptoms such as dysphagia, neck tenderness, odynophagia, hypersalivation, regurgitation, and abdominal pain. Radiologic imaging is discussed as a means to locate the object and identify any complications. <br /><br />The document outlines the indications for endoscopic removal of foreign bodies, including the urgency in removing objects to prevent complications such as airway compromise, perforation, and fistula formation. Airway precautions, such as anesthesia with an ET tube for children, mentally ill patients, and uncooperative patients, are recommended. The document also lists the different tools used for endoscopic removal of foreign bodies, such as grasping forceps, retrieval nets, baskets, and hoods.<br /><br />Specific considerations are provided for esophageal food bolus impaction, eosinophilic esophagitis, sharp and pointed foreign bodies, button batteries, and multiple magnets. The complications associated with these objects are discussed, including vocal cord paralysis, esophageal perforation, tracheal stenosis, tracheoesophageal fistula, infection, and death. The document concludes by emphasizing the importance of recognizing the indications for urgent endoscopy, contraindications for endoscopic retrieval, and planning the strategy before the procedure. It also underscores the importance of protecting the airway through careful choice of sedation or anesthesia.

Keywords

foreign bodies

food impactions

gastrointestinal tract

endoscopy timing

anatomical location

high-risk objects

airway protection

esophageal perforation

radiologic imaging

endoscopic removal