What predictive parameters best indicate the need for emergent gastrointestinal endoscopy after foreign body ingestion?
Our aim was to determine what parameters may be used to indicate an emergent endoscopy after foreign body (FB) ingestion and to ascertain how often FBs are found endoscopically. Demographic data, gastroesophageal antecedents, clinical and endoscopic data, and complications were obtained. We examined 122 patients endoscopically. The onset of symptoms was immediate after FB ingestion in 93% of patients. Dysphagia was the most frequent symptom (66%), with the pharynx the most frequent location of impaction (71%). Endoscopy confirmed the presence of FBs in 52% of patients. Extraction was performed in 78%. The immediate onset of symptoms, dysphagia, and the absence of pharynx localization of impaction were predictive indicators of a positive FB finding (p < 0.05), with diagnostic sensitivity of 86% and specificity of 63%. Upper endoscopy should be performed in all patients with FB ingestion, even though no FB was found in 48%.
Gastrointestinal Endoscopy Division, Hospital del Bierzo, León, Spain. constanz@airbierzo.com
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Ciriza
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García
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Suárez
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Jiménez
M J
MJ
Romero
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O
Urquiza
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Dajil
D003680:Deglutition Disorders / Q000209:etiology; D004638:Emergency Treatment; D016099:Endoscopy, Gastrointestinal; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010614:Pharynx; D011446:Prospective Studies