A Unique Pattern of True Foreign‑Body Ingestion: High frequency of sharp foreign body ingestion in Kashmir

Abstract

Background and Aims: Foreign‑body ingestion is common, especially in children. However, in adults, foreign‑body ingestion is usually accidental, and mostly ingestion occurs with food, and the impaction is a result of structural abnormalities of the upper gastrointestinal tract (UGIT). However, accidental ingestion of nonfood products is unusual; especially ingestion of pins (scarf or safety pins) and needles is unknown. Nevertheless, we have come across ingestion of these sharp foreign bodies routinely over the past few years.

This study aimed to observe, over one year, the spectrum of nonfood or true foreign‑body ingestion in our community and to see the impact of an early endoscopy on the outcome or retrieval of the ingested objects.

Materials and Methods: In a prospective observational study, we studied the profile of foreign‑body ingestion in normal individuals of all ages and sexes, excluding individuals with any structural abnormalities of the gut and those with psychiatric ailments.

Results: Of the total 51 patients with true foreign‑body ingestion, 42 (82%) were 20 or less than 20 years of age, with females constituting 86.3% of the total and males constituting only 13.7%. Foreign bodies ingested included 38 pins (74.5%), seven coins (13.7%), four needles (7.8%), and one denture and a nail (2%) each. Overall, 26 (51%) foreign bodies were seen in UGIT within reach of retrieval at endoscopy, and all of them were removed. Nineteen (37.3%) patients reported within six h of ingestion, and the majority of them, 16 (84.2%), had foreign bodies within UGIT, and all of them were removed. Thirty-two (62.7%) of patients who reported beyond six h, only 10 (31.25%) had foreign bodies in UGIT. As a result, the success rate of removal in these patients was only 32%.

Conclusion: Most of our patients were young females, and the common foreign bodies ingested were sharp, including scarf pins followed by coins and needles. The success rate of retrieval was high in those who reported within six h of ingestion of a foreign body. The retrieval rate was 100% if a foreign body was found on esophagogastroduodenoscopy.

Hence, we recommend an early endoscopy in these patients and some alternatives to using scarf pins.