The management of ingested foreign bodies in the upper digestive tract: a retrospective study of 49 cases

Forty-nine cases of accidental foreign body ingestion treated in our unit were reviewed. Fish bones were the commonest foreign body ingested by adults while coins and pins accounted for most cases in the paediatric age group. All except one patient had endoscopy performed, majority with flexible endoscope. Foreign bodies were detected and successfully removed endoscopically in 23 patients except one. In another 12 patients, foreign bodies were demonstrated by chest X-ray or Barium meal but at the time of endoscopy, they had passed beyond the reach of the endoscope. For the remaining 13 patients, despite having a history of foreign body ingestion and retrosternal pain, subsequent investigation failed to demonstrate the foreign bodies. Barium contrast studies were performed in 31 cases, with 5 false negative and 2 possible false positive findings. There were 2 serious complications related to foreign body ingestion, one had empyema thoracis and another died of massive bleeding due to esophageal carotid fistula.