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.
Pavlidis
Theodoros E
TE
Second Propedeutical Department of Surgery, Medical School, Hippocration Hospital, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 546 42 Thessaloniki, Greece. pavlidth@med.auth.gr
Marakis
Georgios N
GN
Triantafyllou
Apostolos
A
Psarras
Kyriakos
K
Kontoulis
Theodoros M
TM
Sakantamis
Athanasios K
AK
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