Management of ingested foreign bodies. How justifiable is a waiting policy?
Foreign body ingestion is a commonly seen accident in emergencies, usually in children (80%), elderly, mentally impaired, or alcoholic individuals, whereas it may occur intentionally in prisoners or psychiatric patients. According to the literature, 90% of ingested foreign bodies pass through the gastrointestinal tract without complications, 10% to 20% necessitate endoscopic removal, whereas only 1% of them will finally need surgical intervention. In clinical practice, we often face the dilemma of choosing the appropriate treatment modality. We present 13 cases treated in our department, emphasizing in a "waiting and close observation" policy. Among these cases, only 1 patient needed to be operated because of obstruction of ileocecal valve by a large coin. Indications for treatment where applicable are also being discussed.
Second Propedeutical Department of Surgery, Medical School, Hippocration Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 546 42 Thessaloniki, Greece. pavlidth@med.auth.gr
Theodoros E
TE
Pavlidis
Georgios N
GN
Marakis
Apostolos
A
Triantafyllou
Kyriakos
K
Psarras
Theodoros M
TM
Kontoulis
Athanasios K
AK
Sakantamis
D000293:Adolescent; D000328:Adult; D000368:Aged; D003657:Decision Making; D004632:Emergency Medical Services / Q000592:standards*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005547:Foreign Bodies / Q000601:surgery* / Q000628:therapy; D005548:Foreign-Body Migration / Q000601:surgery* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors