Epidemiological Aspects and Predictive Factors of Failure in Endoscopic Foreign Body Removal

Aims The ingestion of foreign bodies is a common emergency in gastroenterology, requiring prompt management to prevent potentially serious complications. Although the outcome is spontaneously favorable in the majority of cases, urgent endoscopic extraction is necessary in certain situations. The aim of our study is to examine the epidemiological characteristics and management methods of foreign body ingestion in our series, as well as to determine the predictive factors for failure in endoscopic extraction.

Methods This is a retrospective, single-center study including all patients who ingested a foreign body and were treated in our upper gastrointestinal endoscopy unit between January 1991 and October 2024.

Results We included 126 patients, with a mean age of 29.26±16.42 years and a male-to-female ratio of 2.5. The ingested foreign body was a sharp object in 31.7% of cases. It involved food impaction in 23.8% (n=30) of cases, coin ingestion in 17 cases (13.5%), dental material in 6 cases (4.7%), and pins in 11 female patients. The most common site of impaction was the stomach in 56.3% of cases, and the foreign body was not found during upper gastrointestinal endoscopy in 9 patients. Endoscopic lesions were observed in 13.5% of cases, mainly abnormalities in the esophagus in 15 patients, with peptic esophagitis being the most frequent lesion. The two most commonly used extraction tools were the polypectomy snare and biopsy forceps, with a tripod forceps used in 2 cases and an esophagoscope in one case. Extraction was successful in 60.3% of cases. The food-type foreign body was pushed into the stomach in 5.6% of cases, and surgical intervention was necessary for 14 patients (11.1%). A minor bleeding ooze in one case of chicken bone ingestion was the only complication observed. In univariate analysis, only the use of biopsy forceps was a predictive factor for failure, with a p-value of 0.015. The sharp nature of the object and the presence of underlying endoscopic lesions were not associated with extraction failure in our study (p=0.6).

Conclusions The extraction of ingested foreign bodies via upper gastrointestinal endoscopy is a fairly common procedure in emergency endoscopic practice, with an overall success rate that is generally encouraging. The main predictive factor for failure was the use of biopsy forceps as an extraction tool.

Publication History

Article published online:
27 March 2025