Steven Delaney, MD1, Zach Harris, MD1, Steven Clayton, MD2; 1Wake Forest Baptist Health, Winston-Salem, NC; 2Wake Forest University, School of Medicine, Winston-Salem, NC
Introduction: Esophageal and gastric foreign bodies classically involve food in adults and coins, toys, batteries, magnets, marbles, and other small objects in children. However, limited studies have been published regarding the removal of iatrogenic foreign bodies. We aimed to catalog and analyze a comprehensive spectrum of foreign bodies removed by EGD. We accomplished this by comparing the findings and management of the foreign bodies by dividing them into three major groups: food based, iatrogenic, and “others” (intentional and unintentional non-food ingestions) to detect if there were significant differences. Methods: We conducted a retrospective review of all foreign bodies removed via EGD over a 3-year period. Our study was IRB approved and conducted at a tertiary medical center. We collected demographic variables, medical history, objects removed, removal method, and outcomes. All of these cases were analyzed with descriptive statistics. Categorical data was analyzed using the Chi-Square test while quantitative data was analyzed by ANOVA. A p-value < 0.05 was considered significant. Results: Over a 3-year period, there were 401 encounters for foreign body removed by EGD. Iatrogenic made up the majority of the encounters with 232 patients, followed by food at 136, and “others” (intentional and unintentional non-food ingestions) at 33. As presented in table 1, when comparing the three groups, we found significant differences in age (p< 0.05), gender (p< 0.001), insurance status (p=0.002), PCP status (p=0.002), if follow up was scheduled (p< 0.001), and if the patient presented to follow-up (p=0.032). In addition, there were significant differences in the removal method between groups when comparing single vs. multiple modalities and graspers vs. non-graspers (p< 0.001). When combining all 3 groups together, utilizing a single device compared to multiple devices was more common and successful (79.8% vs 20.2%, p< 0.001). The top object removed was food in 132 cases followed by staples in 98 patients. Discussion: We aimed to study differences between the complete spectrum of upper GI foreign bodies. Dividing the data between 3 major categories, we found multiple differences between demographics and successful removal methods. We were also able to list the objects removed. Inclusion of all objects including iatrogenic should shed light on what is being removed along with removal method for a typical GI department at tertiary medical center.
*Intentional and unintentional non-food ingestions. Table 1: Demographics.
*Intentional and unintentional non-food ingestions. Figure 1: Extraction Device or Method as a Total and Divided between Groups.
Figure 2: Objects Extracted.
Disclosures: Steven Delaney indicated no relevant financial relationships. Zach Harris indicated no relevant financial relationships. Steven Clayton indicated no relevant financial relationships.