Ingested foreign material in mentally disturbed patients

Advances in endoscopic technology and its enthusiastic clinical application have resulted in the capability of retrieving most ingested foreign objects from the upper gastrointestinal tract. Although endoscopic removal of foreign bodies is generally safe, it is not always clearly indicated. Foreign bodies in the esophagus usually require prompt intervention. In contrast, objects are frequently retained in the gastric lumen for long periods without adverse consequences. Psychotic or demented patients are a major adult group at risk for foreign body ingestion. Because endoscopy in this group often carries additional risks, and since smooth objects are usually well tolerated in the stomach for long periods, we recommend a conservative approach in this circumstance.