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World Journal of Surgery

, Volume 20, Issue 8, pp 1001–1005 | Cite as

Ingested Foreign Bodies of the Gastrointestinal Tract: Retrospective Analysis of 542 Cases

  • Nadko G. Velitchkov
  • Georgi I. Grigorov
  • Julian E. Losanoff
  • Kirien T. Kjossev

Abstract. Ingested foreign bodies (FBs) present a common clinical problem. As the incidence of FBs requiring operative removal varies from 1% to 14%, it was decided to perform this study and compare the data with those from the world literature, as well as to outline an algorithm for management, including indications for surgery. We reviewed all patients with FB ingestion from 1973 to 1993. There were 542 patients with 1203 ingestions, aged 15 to 82 years. Among them, 69.9% (

n = 379) were jail inmates at the time of ingestion, 22.9% ( n = 124) had a history of psychosis, and 7.2% ( n = 39) were alcoholics or denture-wearing elderly subjects. Most foreign bodies passed spontaneously (75.6%; n = 410). Endoscopic removal was possible in 19.5% ( n = 106) and was not associated with any morbidity. Only 4.8% ( n = 26) required surgery. Of the latter, 30.8% ( n = 8) had long gastric FBs with no tendency for distal passage and were removed via gastrotomy; 15.4% ( n = 4) had thin, sharp FBs, causing perforation; and 53.8% ( n = 14) had FBs impacted in the ileocecal region, which were removed via appendicostomy. Conservative approach to FB ingestion is justified, although early endoscopic removal from the stomach is recommended. In cases of failure, surgical removal for gastric FBs longer than 7.0 cm is wise. Thin, sharp FBs require a high index of suspicion because they carry a higher risk for perforation. The ileocecal region is the most common site of impaction. Removal of the FB via appendicostomy is the safest option and should not be delayed more than 48 hours.

Keywords

High Risk Retrospective Analysis Foreign Body Elderly Subject Common Site 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirugie 1996

Authors and Affiliations

  • Nadko G. Velitchkov
    • 1
  • Georgi I. Grigorov
    • 1
  • Julian E. Losanoff
    • 1
  • Kirien T. Kjossev
    • 2
  1. 1.Department of Emergency Surgery, Military Medical Academy, 3 Georgi Sofijski Boulevard, 1606 Sofia, BulgariaBG
  2. 2.Department of General Surgery, Military Medical Academy, 3 Georgi Sofijski Boulevard, 1606 Sofia, BulgariaBG

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