CONSERVATIVE MANAGEMENT OF FOREIGN-BODIES IN THE GASTROINTESTINAL-TRACT

There are at present no clear guidelines whether foreign body ingestio n in the gastrointestinal tract should be managed conservatively, endo scopically or surgically. Retrospectively we have, therefore, analyzed 78 foreign body ingestion's in 42 patients (age 15-72 years) admitted to the Emergency Department of the University Hospital in Vienna. Our intention was to assess the value of a conservative management, defin ed as daily feliow-up visits until the foreign body spontaneously appe ared in the feces and to find criteria when endoscopic or surgical man agement ist required. Of 78 foreign bodies, 67 (86%) passed the gastro intestinal tract spontaneously without complications, 9 (11%) were rem oved endoscopically, and only 2 (3%) required surgery. There were no g astrointestinal perforations. Even foreign bodies with a maximal lengt h of 13,5 cm appeared in the feces spontaneously within a few days. Ou r data suggests that more than 80% of adults with foreign body ingesti on can be managed safely as outpatients by means of conservative treat ment. Endoscopic or surgical removal is only indicated in very rare ci rcumstances.