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Related Experiment Videos

This too shall pass: A study of ingested sharp foreign bodies.

Kirellos R Zamary1, James W Davis, Emily E Ament

  • 1From the Department of Surgery (K.R.Z., J.W.D., E.E.A., R.C.D., J.E.G.) UCSF Fresno, Fresno, CA 93721.

The Journal of Trauma and Acute Care Surgery
|November 3, 2016
PubMed
Summary

Sharp gastrointestinal foreign body ingestion rarely requires surgery. Most patients with sharp foreign bodies in the GI tract can be managed non-surgically, with endoscopic removal for larger objects.

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Area of Science:

  • Gastroenterology
  • Acute Care Surgery

Background:

  • Gastrointestinal foreign body (GFB) ingestion is a frequent clinical issue, often necessitating surgical consultation.
  • Limited data exists on the management of sharp GFB ingestions, with current literature primarily comprising case reports.

Purpose of the Study:

  • To investigate the outcomes of sharp gastrointestinal foreign body ingestions.
  • To determine the rate of perforation or obstruction requiring surgical intervention in patients with sharp GFB ingestion.

Main Methods:

  • Retrospective review of patients presenting with sharp GFBs between January 2005 and December 2015 at a level 1 trauma center.
  • Exclusion of cases with non-ingested, unknown, or blunt GFBs, or those not found on imaging.
  • Data collection included demographics, length of stay, imaging, and interventions.

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Main Results:

  • Out of 192 visits for sharp GFB ingestion, 169 patients were included. 69% required no intervention, and 79% had no procedure or a negative procedure.
  • Surgery was performed in only 4% of patients (seven individuals), with five experiencing peritonitis.
  • Endoscopic removal was performed in 30 cases; objects removed surgically were significantly larger than those managed non-surgically.

Conclusions:

  • Sharp gastrointestinal foreign body ingestion infrequently necessitates surgical intervention (4%).
  • Most patients (79%) can be managed non-surgically, with discharge and return precautions, psychiatric care, or return to custody.
  • Larger upper gastrointestinal sharp foreign bodies should be considered for endoscopic removal.