ENDOSCOPIC MANAGEMENT OF FOREIGN BODIES IN UPPER GASTROINTESTINAL TRACT.
Waseem Raja*, MD, DNB. Rohey Jan, MD, S. K. Mathai, MD, D.M.B. Sebastian, MD, D.M. Salma Maryam and Abid Hussain Mir
ABSTRACT
Background: Foreign body ingestion is one of the commonest indication for emergency endoscopy. Removal of FBs has always been a challenge for an endoscopist. The aim of this study is to to assess the magnitude and spectrum of FBs among patients admitted in our Gastroenterology units. Methods: A hospital based retrospective study was conducted at Medical Trust Hospital Kochi- Kerala, one of the tertiary care referral centre, in South india over a period of 2 years. We reviewed all patients’ files with full notations on age, sex, type of FB and its anatomical location, treatments, and outcomes (complications, success rates, and mortalities). Patients with incomplete files and those with FBs not identified at the endoscopic examination were excluded. Results: A total of 57 patients were identified. Their ages ranged from 6 months to 85 years. Slight male predominance was noticed (52.6%). The most frequent presentation was a history of FB ingestion without any associated manifestations (52.6%). Fish bones were the most commonly encountered FBs 43.8% (25/57) and majority of FBs 43.8% were removed within 6-12 hours .Upper esophagus was the most common site of trapping 38.5% (22/57). The overall success rate was 96.4% (55/57). Upper endoscopy successfully resolved the problem by either FB removal 78.9% (45/57) or dislodgment of the impacted fleshy meat bolus to the stomach 21% (12/57). The rate of complications was 3.5%. Furthermore, no mortalities due to FB ingestion or removal had been reported throughout the study. Conclusion: Our experience with FB removal emphasizes its importance and ease when performed by experienced hands, at well-equipped endoscopy units and under conscious sedation in most cases, with high success rates and minor complications.
Keywords: upper endoscopy, Fish bones, FB (Foreign body), fleshy meat, forceps.
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