Hannah Byrne1, Manna Blesson2, Jaiden Townsend3, William Braithwaite3, Diego Dumpierres1
1Northampton General Hospital, Northampton, United Kingdom. 2University of Leicester - Medical School, Leicester, United Kingdom. 3University College London - Medical School, London, United Kingdom
Aim: ‘True’ foreign body ingestion (TFBI) is defined as a non-edible object entering the gastrointestinal tract. It is typically encountered in the paediatric population, but when seen in adults is associated with specific populations, including those with psychiatric disorders. A psychiatric hospital is nearby to our site and referrals for TFBI is not uncommon. We aimed to review our day case management of TFBI and analyse trends in presentation, clinical decision making and patient outcomes.
Method: The hospital coding department identified all admissions linked with the term ‘foreign body’, over a 9 year period (2009 – 2018). Following exclusions, a total of 67 patients were identified, generating 143 separate presentations.
Results: 79% of TFBI presentations were managed as day cases. Of these, 75% were managed conservatively and 23% underwent an oesophagogastroduodenoscopy (OGD) and removal of the object. 100% of cases involving ingestion of small metallic/plastic objects were managed as day cases, compared to 52% in cases involving a hazardous object (>6cm in length, or sharp). 59% of patients had subsequent TFBI admissions, with 27% of these patients having 3 or more separate presentations.
As with any clinical management plan, decisions should centre around a patient’s condition at presentation and their expected clinical progress. Our results show that the majority of TFBI cases were managed successfully as day cases. Interestingly, the risk of recurrent presentations was also highlighted. This suggests further education and support is required for clinicians, caregivers and patients, so as to prevent ongoing morbidity/mortality risks.