Endoscopic Foreign Body Retrieval - Indications and Contraindications

Indications and Contraindications

Some patients at risk for foreign body ingestion may not be able to give an accurate medical history of ingestion, either due to age or mental illness. It is important that physicians treating these patients recognize the symptoms of esophageal foreign body impaction requiring urgent intervention. Most frequently, these include drooling and the inability to swallow saliva, neck tenderness, regurgitation of food, stridor and shortness of breath if there is compression of the trachea.

There are several situations in which endoscopic techniques are not indicated, such as for small blunt objects less than 2.5 cm which have already passed into the stomach (as these usually do not obstruct anywhere else), when there is perforation of the esophagus or mediastinitis (inflammation of structures around the esophagus), and for narcotic-containing bags or condoms that have been ingested, because of the risk of overdose if they are ruptured.

Foreign bodies should be removed from the esophagus within 24 hours of ingestion because of a high risk of complication.

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