Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion.
BACKGROUND
Previous reports of foreign-body ingestions focused primarily on accidental ingestions.


OBJECTIVE
To describe the characteristics and management of foreign-body ingestions, with predominantly intentional ingestion, in a lower socioeconomic status population.


METHODS
A retrospective case series.


METHODS
An urban county hospital.


METHODS
Patients >/=17 years old, with foreign-body ingestions between 2000 and 2006.


METHODS
Characteristics of ingestion cases, endoscopic extraction, need for surgery, and complications.


RESULTS
Among 262 cases, 92% were intentional, 85% involved psychiatric patients, and 84% occurred in patients with prior ingestions. The time from ingestion to presentation was >48 hours in 168 cases (64%). The overall success rate for endoscopic extraction was 90% (165/183 cases). Surgery was performed in 30 cases (11%) and was more common for objects beyond the pylorus versus objects above the pylorus (16/43 [37%] vs 10/151 [7%], respectively) and in cases with a greater delay from ingestion to presentation (25/168 [15%] if >48 hours vs 4/77 [5%] if </=48 hours) and from presentation to intervention (15/40 [38%] if >48 hours vs 14/165 [8%] if </=48 hours). Perforation occurred in 16 cases (6%), with 6 perforations noted after endoscopy.


CONCLUSIONS
A retrospective review of medical records.


CONCLUSIONS
Foreign-body ingestions in an urban county hospital occurred primarily in psychiatric patients who had repeated episodes of intentional ingestions. Endoscopic extraction was unsuccessful in 10% of cases. Long delays from ingestion to presentation and intervention may account for relatively high rates of surgery and perforation. Strategies to prevent ingestions and delays in endoscopic management are needed in this population.
Palta
Renee
R
Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Sahota
Amandeep
A
Bemarki
Ali
A
Salama
Paul
P
Simpson
Nicole
N
Laine
Loren
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D005547:Foreign Bodies / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016728:Self-Injurious Behavior; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult