Management of Ingested Foreign Bodies
2005; Pulsus Group; Volume: 19; Issue: 10 Linguagem: Inglês
10.1155/2005/516195
ISSN1916-7237
Autores Tópico(s)Esophageal and GI Pathology
ResumoThe majority of foreign bodies are ingested. Up to 90% of these will pass through the gastrointestinal tract spontaneously, 10% to 20% require endoscopic management and approximately 1% require surgical management (1). The pediatric population is most at risk, accounting for 80% of ingested foreign bodies. Adults, especially the mentally impaired, alcoholic and edentulous, may also accidentally ingest a foreign body. Prisoners and psychiatric patients may ingest foreign bodies intentionally for secondary gain, for instance, to instigate transfer to hospital from a prison or psychiatric institution. Purposeful ingestion of foreign bodies for the purpose of drug trafficking also occurs. Ingestion of multiple foreign bodies should always be considered in both children and adults. Among children and mentally impaired adults, commonly ingested objects include coins, small toys, crayons and batteries. In adults, the most common foreign body ingested is a poorly chewed bolus of meat, a bone or dentures. Intentional ingestion of a foreign body by a prisoner or psychiatric patient is often a razor blade or other sharp metallic object. The diagnosis is apparent from the patient’s history. The patient will often report a sudden onset of dysphagia during a meal, which may be accompanied by chest pain or odynophagia and an inability to tolerate secretions. In children or adults unable to provide a history, a sudden refusal to eat, drooling or respiratory symptoms such as coughing or wheezing due to aspiration are reasons to suspect foreign body ingestion. A careful physical examination should be performed to
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