title: [Management of impacted foreign bodies in the upper gastrointestinal tract in adult patients - results of a retrospective case series].
abstract: BACKGROUND
  Impaction of foreign bodies in the upper gastrointestinal tract represents a rare endoscopic emergency regarding the danger of organic lesions. Therefore, the therapeutic strategy, rational postinterventional monitoring and potential consequences for the course in the future are often not clear.
  
  
  METHODS
  Out of all oesophagogastroduodenoscopies performed between 2008 and 2010 (n = 10,830), the endoscopies due to bolus impaction were analysed retrospectively concerning endoscopic findings, course of intervention and causative predisposing factors using descriptive statistics.
  
  
  RESULTS
  In the study period, endoscopy was performed in 45 different patients 49 times when foreign body impaction was suspected. In 38 cases (77.6%) a foreign body could be detected by endoscopy, most frequently a meat bolus (65.8%), followed by dental prostheses and tablets. Endoscopic removal could be successfully performed in 97.4%. An operation was necessary in only one patient. A macroscopically unremarkable upper gastrointestinal tract without any predisposing conditions for foreign body impaction could be detected in 33.3%. In one case eosinophilic oesophagitis could be diagnosed histologically. The foreign body was pushed into the stomach by the "push technique" in 54.1%. The foreign body removal was performed as an ambulant intervention in 63.2%.
  
  
  CONCLUSIONS
  In the majority of cases, impacted foreign bodies of the upper gastrointestinal tract could be removed safely by endoscopy, e.g., using the "push technique". However, the therapeutic strategy should be individually adjusted based on the consistancy of the foreign body. If no predisposing conditions can be found, histological diagnosis should be performed to detect potential eosinophilic oesophagitis early enough.
authors.affiliation: Klinik für Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, Klinikum Bogenhausen, Städtisches Klinikum München GmbH, Akademisches Lehrkrankenhaus der Technische Universität München, München. Felix.Gundling@GMX.de
authors.forename: F
authors.initials: F
authors.lastname: Gundling
authors.forename: H
authors.initials: H
authors.lastname: Seidl
authors.forename: T
authors.initials: T
authors.lastname: Stark
authors.forename: A
authors.initials: A
authors.lastname: Schneider
authors.forename: W
authors.initials: W
authors.lastname: Schepp
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005260:Female; D005547:Foreign Bodies / Q000453:epidemiology* / Q000601:surgery*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012307:Risk Factors; D016896:Treatment Outcome; D041742:Upper Gastrointestinal Tract / Q000293:injuries*; D055815:Young Adult