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Missed Foreign Body Ingestion in a Cognitively Impaired Adult: A Case Report
1General Medicine, Aneurin Bevan University Health Board, Cwmbran, GBR.
Cureus
|August 4, 2025
Summary
Foreign body ingestion can be difficult to diagnose without a clear patient history. This case highlights how impacted esophageal foreign bodies can mimic gastritis, emphasizing the need for timely endoscopy.
Area of Science:
- Gastroenterology
- Diagnostic Imaging
- Emergency Medicine
Background:
- Foreign body ingestion diagnosis relies heavily on patient history.
- Cognitive impairment can obscure the history of ingestion, leading to diagnostic challenges.
- Delayed diagnosis of esophageal foreign bodies can result in serious complications.
Observation:
- A cognitively impaired adult presented with vomiting, initially misdiagnosed as gastritis.
- The actual cause was foreign bodies impacted within the esophagus.
- This diagnostic delay occurred due to the inability to obtain a clear ingestion history.
Findings:
- Esophageal foreign bodies can present with symptoms mimicking common gastrointestinal conditions like gastritis.
- Endoscopic evaluation is crucial for accurate diagnosis in suspected foreign body ingestion.
- Adherence to European Society of Gastrointestinal Endoscopy (ESGE) guidelines aids timely intervention.
Implications:
- Early endoscopic intervention, guided by ESGE standards, can prevent severe complications from esophageal foreign bodies.
- This case underscores the importance of considering foreign body ingestion in patients with altered mental status and unexplained GI symptoms.
- Improved diagnostic strategies are needed for foreign body ingestion in vulnerable populations.
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