Predictors of Outcomes in Endoscopies for Foreign Body Ingestion: A Cross-Sectional Study

Abstract

Background

As foreign body ingestion/food impaction is one of the less common indications for upper endoscopy in adults, few studies have investigated outcomes. We aimed to determine the distribution of ingested items warranting endoscopy and to identify factors associated with successful endoscopic retrieval.

Methods

We conducted a retrospective, cross-sectional study, identifying all endoscopies performed between June 2006 and June 2018 for foreign body ingestion or food impaction. We performed univariate and multivariate analyses to identify variables associated with endoscopic foreign body visualization and successful removal from the mouth.

Results

Of the 168 endoscopies identified, the ingested item was visualized in 131 (78%) and was removed from the mouth in 88 (52.4%). 6.5% of cases required surgery and 2.4% of cases had a perforation noted. The two most common foreign bodies were food boluses (51.2%) and bones (28.6%). Older patients were more likely to have their ingested foreign body visualized during endoscopy (age ≥ 70 compared to 18–29 adjusted odds ratio [aOR] 8.78; 95% CI 1.62–47.70) and more likely to have it removed from the mouth (aOR 5.57; 95% CI 1.34–22.85). Bones were less likely to be visualized on endoscopy (aOR 0.16; 95% CI 0.04–0.57) but not less likely to be removed successfully (aOR 0.85; 95% CI 0.42–1.72). Foreign bodies visible on radiography were more likely to be identified on endoscopy (aOR 9.07; 95% CI 2.71–30.37) and more likely to be successfully removed (aOR 2.82; 95% CI 1.26–6.32).

Conclusions

Factors such as age, radiographic visibility, and the suspected foreign body may affect the likelihood that it can be visualized and removed. Future studies should focus on further characterizing complications of foreign body ingestions and the types of patients and objects most at risk.