Endoscopy 2001; 33(8): 692-696
DOI: 10.1055/s-2001-16212
Original Article

© Georg Thieme Verlag Stuttgart · New York

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract: Report on a Series of 414 Adult Patients

S. Mosca, G. Manes, R. Martino, L. Amitrano, V. Bottino, A. Bove, A. Camera, C. De Nucci, G. Di Costanzo, M. Guardascione, F. Lampasi, S. Picascia, F. P. Picciotto, E. Riccio, V. P. Rocco, G. Uomo, A. Balzano
  • Dept. of Gastroenterology, A. Cardarelli Hospital, Naples, Italy
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Background and Study Aims: Ingestion of foreign bodies is a common occurrence. Few papers in the literature report experience and outcome at tertiary centers. The aim of this paper is to report the management and the outcomes in 414 patients admitted for suspected ingestion of foreign body between May 1995 and December 1999.

Methods: A plain radiographic film of the neck, chest or abdomen was obtained in the case of radiopaque objects, and in order to rule out suspected perforation: in such cases a computed tomography (CT) study was also performed. All patients were asked to give their informed consent, which was refused by three patients. Anesthesia was always used, either conscious sedation (86.8 %), or general anesthesia in the case of poor patient tolerance (13.2 %). All patients underwent an endoscopic procedure within six hours of admission. A flexible scope was used in all patients and a wide range of endoscopic devices was employed.

Results: Foreign bodies were found in 64.5 % of our patients. Almost all were found in the esophagus. The types of foreign body were very different, but they were chiefly food boluses, bones or cartilages, dental prostheses or fish bones. In three patients (1.1 %) it was impossible to endoscopically remove the foreign body, which was located in the cervical esophagus: all these three patients required surgery. No complications relating to the endoscopic procedure were observed, but 30.7 % of patients had an underlying esophageal disease, such as a stricture. Only eight patients required a second endoscopic procedure, performed by a more experienced endoscopist.

Conclusion: Foreign body ingestion represents a frequent reason for emergency endoscopy. The endoscopic procedure is a successful technique which allows the removal of the foreign bodies in almost all cases without significant complications. Surgery is rarely required.


  • 1 Schwartz G F, Polsky H S. Ingested foreign bodies of the gastrointestinal tract.  Am Surg. 1976;  42 236-238
  • 2 Ginsberg G G. Management of ingested foreign objects and food bolus impactions.  Gastrointest Endosc. 1995;  41 33-38
  • 3 Berggreen P J, Harrison E, Sanowski R A, et al. Techniques and implications of esophageal foreign body extraction in children and adults.  Gastrointest Endosc. 1993;  39 626-630
  • 4 Webb W A. Management of foreign bodies of the upper gastrointestinal tract: update.  Gastrointest Endosc. 1995;  41 39-51
  • 5 Arcidiacomo R, Rossi A, Grosso C. Linee guida in tema di ingestione di sostanze caustiche e di corpi estranei. In: Balzano A, Mosca S (eds.) Emergenze in gastroenterologia. Rome; II Pensiero Scientifico 1998: 11-24
  • 6 Ricote G C, Torre L R, DeAyala V P, et al. Fiberendoscopic removal of foreign bodies of the upper part of the gastrointestinal tract.  Surg Gynecol Obstet. 1985;  160 499-500
  • 7 Kim J K, Kim S S, Kim J I, et al. Management of foreign bodies in the gastrointestinal tract: an analysis of 104 cases in children.  Endoscopy. 1999;  31 302-304
  • 8 Brady P G. Management of esophageal and gastric foreign bodies. Clinical updates. ASGE online 1998
  • 9 Alaradi O, Bartholomew M, Barkin J S. Upper endoscopy and glucagon: a new technique in the management of acute esophageal food impaction (abstract).  Am J Gastroenterol. 1998;  93 1609
  • 10 Mosca S. Management and endoscopic techniques in cases of ingestion of foreign bodies.  Endoscopy. 2000;  32 232-233
  • 11 Lee S, Chun H J, Jeen Y T, et al. Removal of upper gastrointestinal sharp and pointed foreign bodies using endoscopic protector hood (abstract).  Gastrointest Endosc. 1999;  49 113
  • 12 Gotti R, Rizzolo M, Fucile V, et al. Denture: an unusual foreign body ingestion. Experience on 160 cases (abstract).  Gastrointest Endosc. 1999;  49 112
  • 13 Pezzi J S, Shiau Y F. A method for removing meat impaction from the esophagus.  Gastrointest Endosc. 1994;  40 634-636
  • 14 Saaed Z A, Michatete P A, Feiner S D, et al. A new endoscopic method for managing food impaction in the esophagus.  Endoscopy. 1990;  22 226-228
  • 15 Kozarek R A, Ball T J, Belic L, et al. Food impaction at a regional referral center: should we push? Pull? Or Poke? (abstract).  Gastrointest Endosc. 1999;  49 113
  • 16 Vicari J J, Johanson J F, Frakes J T, et al. Outcomes of acute esophageal food impaction: to push or pull? (abstract).  Gastrointest Endosc. 1999;  49 113
  • 17 Chu K M, Choi H K, Tuen H H, et al. A prospective randomized trial comparing the use of the flexible gastroscope versus the bronchoscope in the management of foreign body ingestion.  Gastrointest Endosc. 1998;  47 23-27
  • 18 Faigel D G, Stotland B R, Kockman M L, et al. Device choice and experience level in endoscopic foreign object retrieval: an in vivo study.  Gastrointest Endosc. 1997;  45 490-492

S. Mosca, M.D.

Dept. of Gastroenterology
A. Cardarelli Hospital

Via Monte di Dio, 74
80132 Naples

Fax: + 39-081-7472232

Email: samo@inwind.it