title: Diagnosis and endoscopic management of upper gastrointestinal foreign bodies.
abstract: BACKGROUND
  The objective is to evaluate the diagnosis of foreign body (FB) ingestion and report on the endoscopic management in Taiwan.
  
  
  METHODS
  This retrospective study enrolled 159 adult patients with confirmed diagnosis of upper gastrointestinal FBs who received endoscopic management in the emergency department.
  
  
  RESULTS
  The patients' mean age was 57.0 ± 19.2 years, and 66 (37.7%) of the patients were 65 years or older. Majority had a clear history and symptoms of FB ingestion. However, 9 (5.7%) initially ignored the accidental swallowing of FBs and were diagnosed late. The mean time spent for diagnosis was 1.8 days in those with uncertain history. Only 47.1% of those with radiographic studies had positive findings. Fish bones, press-through package and dentures were the most common culprits in this population of Asian elderly. Majority of FBs were located in the esophagus, especially in the upper third. Endoscopic FB extraction was successful in 96.9% of cases, while surgery was required in only 5 patients. The complication rate was 6.9%, including mucosal laceration (n = 10) and suspected perforation (n = 1), all of which were successfully managed conservatively. There was no death due to FB ingestion or endoscopy.
  
  
  CONCLUSIONS
  In FB ingestion, history usually points toward the diagnosis. Patients with an uncertain history are usually diagnosed late, and plain radiography cannot reliably predict the presence of FB. Endoscopic management is safe and effective for FBs.
authors.affiliation: Emergency Department, Taipei Veterans General Hospital, Taiwan.
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chiu
authors.forename: Sen-Kuang
authors.initials: SK
authors.lastname: Hou
authors.forename: Sau-Chin
authors.initials: SC
authors.lastname: Chen
authors.forename: Chorng-Kuang
authors.initials: CK
authors.lastname: How
authors.forename: Carlos
authors.initials: C
authors.lastname: Lam
authors.forename: Wei-Fong
authors.initials: WF
authors.lastname: Kao
authors.forename: David Hung-Tsang
authors.initials: DH
authors.lastname: Yen
authors.forename: Mu-Shun
authors.initials: MS
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041742:Upper Gastrointestinal Tract