Emergency Department Experience of Foreign Body Ingestion, Analysis of 69 cases at an Academic Hospital in Saudi Arabia

Introduction: Foreign body (FB) ingestions represent a challenging clinical problem in the emergency departments (ED), and 20% end up getting endoscopy. We sought to report our experience with FB ingestion based on age, gender, material, comorbidities, and intervention in the ED of XXXXX Hospital where emergency endoscopic service is available.

Methods: This is a retrospective descriptive study of patients who presented to the ED with FB ingestion over a 4-year period (2013-17) and were managed by either upper endoscopy or laparotomy.

Results: A total of 130 patients presented with FB to the ED; we included 69 patients (53%) who were treated by either endoscopy or laparotomy. The majority of cases were single FB (97%), with pediatrics representing (83%) of the cases. The most common age group of ingestion was "0 to 4" years, with a male predominance (57%). The commonest type was metallic in the pediatric group and food in the adult group, with 45% of the patients were symptomatic. Comorbidities were only present in 13% of cases. X-ray was performed in 87% of the cases, whereas CT only in 7%. The esophagus and stomach were the two most common anatomical locations (75%) and (13%), respectively. The upper endoscopy was the commonest procedure performed (93%), and it was almost successfully in all cases from the first attempt (96%).

Conclusions: The FB ingestion is a common occurrence in pediatrics and about half of the cases underwent emergency endoscopy. The availability of such a service is invaluable in the management of FB ingestion given its high success rate and low complications.