Removal of a foreign body from the upper gastrointestinal tract with a flexible endoscope:: a prospective study

Background and Study Aims: There have so far been no prospective studies on the value of flexible endoscopy for removing foreign bodies in the upper gastrointestinal tract. This study presents a clinical analysis of accidents with foreign bodies and prospectively evaluates the effectiveness of flexible endoscopy for removing them. Patients and Methods: A total of 105 cases of foreign-body ingestion in the upper gastrointestinal tract were evaluated, 29 (27.6%) in children and 76 (72.4%) in adults. Thirty patients (28.5%) had esophageal strictures. Results: Thirty-nine of the foreign bodies (37.1 %) consisted of food and 66 (62.9%) were not food-related. The success rate of foreign-body extraction using only a conventional flexible endoscope and accessories for treatment was 98.0%, and with only a polypectomy snare and rat-toothed forceps it was 91.2 %. Complications at the moment of foreign-body removal occurred in nine patients (8.6%); there was only one (1 %) esophageal perforation. The incidence of complications related to the duration of foreignbody impaction was six (10.5 %) with foreign bodies impacted for up to 24 h, 13 (52.0%) for those impacted for 24-48 h, and three (60.0 %) for those impacted for 48 - 72 h (P < 0.05). Conclusions: The flexible encloscope is an effective and safe device for removing foreign bodies from the upper gastrointestinal tract, with a high success rate using only the polypectomy snare and the rat-toothed forceps as accessories. If foreign-body impaction lasts for more than 24 h, there is a significant increase in the incidence of complications.