Common Etiology of Foreign Body Ingestion

Abstract

The aim of this study was to look at the demography, sites of insertion, most common causes of foreign body ingestion and the procedures used for retrieval of these foreign bodies (FB). We also looked at length of stay and common a mental health diagnosis for patients admitted with FB ingestion. Material & Method: This was a retrospective analysis of four years data from January 2014 to January 2018 at Northampton general Hospital. The data was collected using the hospital electronic record system. All patients admitted under surgical subspecialties and gastroenterology was included. Children with a genital FB were excluded from the study. The number of admissions for each patient was recorded. Patients were divided into accidental and mental health illness (MHI) groups. Result: A total of 146 patients were admitted with FB diagnosis. 57% (84) were in the accidental group and 43% (63) were in the MHI group. In the accidental group 70% (54) were under the age of 16 years, the most common cause was inorganic FB and the most common site was an ENT. While in adults most common site in accidental FB was oesophagus and the food bolus was the commonest cause. In the MHI group 63 patients had 257 admissions episodes. The mean age was 25±21 years. Female sex and younger age i.e early adulthood were at a higher risk for FB ingestion. Abdominal x-ray was the most common investigation. Mean length of stay was 3±2 days. Endoscopic retrieval was successful in 85% of patients. Most common mental health diagnosis was deliberate self harm (DSH) 40%. Conclusion: Younger age group, female sex and patients with history of DSH are at a higher risk of FB ingestion and recurrent presentation. Early recognition of high risk patients and prompt psychiatric help can minimise the recurrent presentation of these patients. Minimally invasive techniques like endoscopic retrieval of FB should be first choice.