Foreign body ingestion in adults: clinical challenges and outcomes in high-risk populations presenting to the emergency department.

OBJECTIVE

This study aimed to evaluate the demographic, clinical, and procedural characteristics of adult patients presenting to the emergency department (ED) due to gastrointestinal foreign body ingestion (FBI).

METHODS

This single-center retrospective observational study included adult patients who presented with FBI to a tertiary hospital ED between January 2020 and December 2023. Demographic data, foreign body characteristics, time to presentation, interventions, and clinical outcomes were analyzed.

RESULTS

A total of 198 patients were evaluated. The median age was 38.5 years (interquartile range: 28-59), and 60.1% were male. Recurrent FBI was present in 21.2% and intentional ingestion in 26.3% of cases. Special clinical conditions were observed in 32.8%, including prisoners (18.7%), psychiatric patients (10.6%), and those with esophageal strictures (4.5%). The median time from ingestion to ED presentation was 2 hours (interquartile range: 1-3); significantly longer in the nonendoscopy group (3.5 hours; P  < 0.001). Foreign bodies were most commonly located in the esophagus (35.9%) and stomach (42.9%). Among foreign bodies detected in the esophagus or above, 61.1% were removed endoscopically; in contrast, 79.5% of those located in the stomach or more distal gastrointestinal tract passed spontaneously ( P  < 0.001). Foreign bodies >5 cm required surgery in 13.3% of cases and were associated with longer presentation times. Complications occurred in 17.7% ( n  = 35) of patients, especially after bone-containing meat ingestion (28.6%, P  = 0.001).

CONCLUSION

Early presentation and timely intervention appear to reduce the risk of complications and the need for surgery. High-risk populations, such as incarcerated individuals and patients with psychiatric conditions, may benefit from individualized, multidisciplinary management strategies. These findings underscore the potential value of updating existing clinical guidelines to better address the unique challenges posed by these vulnerable groups.