Comparison of the clinical presentations of ingested foreign bodies requiring operative and nonoperative management

Foreign body ingestion is commonly seen in emergency departments. Although most cases have a clear history, foreign bodies in the gastrointestinal tract can be an unexpected finding after operations for other conditions. This study compares the clinical presentations and outcomes for patients requiring or not requiring operations. Between January 1998 and December 2001, 80 patients with foreign body ingestion were included and divided into two groups. Specifically, group 1 patients were managed nonoperatively, and group 2 patients were managed operatively. The patient demographics, symptoms, foreign body ingestion mechanisms, type of diagnostic studies and management, and outcomes were compared between the two groups. Group 1 contained 44 patients, and group 2 contained 36 patients. Group 1 patients were significantly younger, but the incidence of underlying disease and the proportion of patients who ingested foreign bodies intentionally or incidentally was similar in groups 1 and 2. Most of the ingested foreign bodies in group 1 were in the esophagus and stomach, but for group 2 patients they were mostly in the small bowel. Moreover, most of group 1 patients were asymptomatic, which was not the case in group 2. Most group 2 patients had no known history of foreign body ingestion, and diagnoses generally were established during surgery. Neither group of patients displayed any mortality. Nonoperative management of foreign body ingestion usually can succeed in asymptomatic patients with a clear history; however, ingested foreign bodies can cause serious problems for those patients without a clear history of foreign body ingestion.