Foreign body ingestion - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Foreign body ingestion is a common clinical problem. Those at increased risk include children, older people, people who have an intellectual disability, patients with psychiatric pathologies, prisoners/inmates, and those with underlying gastrointestinal (GI) mechanical obstruction.
Most ingested foreign bodies will pass through the GI tract without symptoms and cause only minor mucosal injury. However, 10% to 20% of cases will require some kind of nonoperative intervention, and 1% or less of cases may develop complications (e.g., bowel obstruction, perforation, severe hemorrhage, abscess formation, or septicemia) and require further surgical interventions.
Endoscopy is considered the first-line intervention for removal of foreign bodies. It is also considered the safest and most reliable method of diagnosis and treatment of foreign bodies in the GI tract.
Other nonoperative techniques for foreign body removal include the use of laryngoscopy, Foley catheters, and esophageal bougienage. Laparoscopic or open surgery is the last resort when other techniques have failed.

Endoscopic photograph of a food impaction in the lower esophagus with evident concentric mucosal ring suggesting eosinophilic esophagitis

From the collection of Juan Carlos Munoz

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Diagnostic and treatment algorithm for foreign body ingestion
Plain abdominal radiology showing foreign body in the stomach lumen
Plain abdominal x-ray showing multiple foreign bodies. There were no signs of intestinal obstruction or perforation
Endoscopic photograph of a food impaction in the lower esophagus with evident concentric mucosal ring suggesting eosinophilic esophagitis
Impacted food bolus removed from lower esophagus
Endoscope view showing foreign bodies in the stomach lumen
Foreign bodies removed from the stomach
(A) Endoscopic view of impacted nail-clipper in the duodenum. (B) Endoscopic removal of tie-clip

Citations

Key Articles

Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr. 2015 Apr;60(4):562-74.[Abstract][Full Text]
Gracia C, Frey CF, Bodai BI. Diagnosis and management of ingested foreign bodies: a ten-year experience. Ann Emerg Med. 1984 Jan;13(1):30-4.[Abstract]
Wai Pak M, Chung Lee W, Kwok Fung H, et al. A prospective study of foreign-body ingestion in 311 children. Int J Pediatr Otorhinolaryngol. 2001 Apr 6;58(1):37-45.[Abstract]
Thabet MH, Basha WM, Askar S. Button battery foreign bodies in children: hazards, management, and recommendations. Biomed Res Int. 2013;2013:846091.[Abstract][Full Text]
Ghahremani GG. Foreign bodies of the alimentary tract. In: Gore RM, Levine MS, Laufer I, eds. Textbook of gastrointestinal radiology. Philadelphia, PA: WB Saunders; 1994:2547-58.
Ikenberry SO, Jue TL, Anderson MA, et al; ASGE Standards of Practice Committee. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011 Jun;73(6):1085-91.[Abstract][Full Text]

Referenced Articles

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