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Hépato-Gastro & Oncologie Digestive

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Management of foreign bodies in the digestive tract Volume 28, issue 1, Janvier 2021

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Tables

Authors
1 Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Pôle des pathologies digestives, hépatiques et de la transplantation, Service d’hépato-gastroentérologie et d’assistance nutritive. 67098 Strasbourg Cedex
2 Clinique Sainte Barbe, Service d’hépato-gastroentérologie, 67000 Strasbourg
* Correspondance

Foreign body ingestion is the second indication for emergency endoscopy. It affects children in more than 70% of cases. In adults, food impactions are the most frequent; they should systematically be checked for an underlying esophageal pathology. Diagnosis is usually easy, based on detailed questioning and X-ray images. It is essential to look for complications (perforation, fistula, gastro-intestinal bleeding, occlusion ...). Ingested objects are mostly found in the esophagus (80%) and to a lesser extent in the stomach (15%). 80 to 90% of ingested foreign bodies progress spontaneously in the gastrointestinal tract. Only 10 to 20% remain impacted, requiring endoscopic management and less than 1% surgical intervention. The indication and time frame for upper gastro-intestinal endoscopy depend on several factors, the main ones being the location and type of foreign body ingested. Only obstructive foreign bodies from the esophagus, button batteries, magnets and intra-esophageal sharps require an absolute emergency endoscopy (< 6 hours). Endoscopic extraction is successful in over 92% of cases and is associated with a low risk of complications (< 5%). Although less common, intra-rectal foreign bodies are not uncommon; surgery may be necessary in case of manual or endoscopic extraction failure.