A Six (6) month prospective study on swallowed foreign bodies presenting to the Ears, Nose and Throat (ENT) surgical department of the San Fernando General Hospital.
Caribbean Medical Journal; Dec2011, Vol. 73 Issue 2, p42-45, 4p, 1 Chart
OBJECTIVES: 1. To determine what are the most common foreign bodies with which patients present to hospital. 2. To estimate the time taken between ingestion of a foreign body and the seeking of medical attention. 3. To assess the effectiveness of a plain radiograph in detecting the presence of swallowed foreign bodies in the upper aerodigestive tract (including the upper 1/3 of the oesophagus). 4. To determine the percentage of patients with normal examination and radiological findings but who are still symptomatic after one week of conservative treatment. 5. To identify the most common sites of foreign body impaction. STUDY DESIGN: A prospective case series SETTING: Tertiary medical centre SUBJECTS AND METHODS: All patients diagnosed with ingestion of a foreign body by the Emergency Department of the San Fernando General Hospital and referred to the Ears, Nose and Throat (ENT) surgical department within the six month study period were included in the audit. A questionnaire was filled out by the attending physician regarding details of the patient's foreign body ingestion, including whether he/she wore dentures. Depending on the persistance of their symptoms, plain laterial radiographs +/- oesophagscopy +/- CT scan, were performed. RESULTS: The most common foreign body swallowed was the fish bone (47.2%). The majority of patients (69.5%) presented to the hospital within twenty four hours after swallowing a foreign body. A lateral radiograph was able to identify a foreign body fifty percent of the time in patients who actually had a foreign body in the upper aerodigestive tract. In patients who were being managed conservatively, 11.1% were still symptomatic on follow up visits. CONCLUSIONS Caution must be exercised when evaluating a patient with a swallowed foreign body. Patients with a history of fish bone ingestion are more likely to have a retained foreign body in the upper aerodigestive tract. A high index of suspicion must still be maintained even after obtaining a normal radiograph as these may only detect half of the foreign bodies. [ABSTRACT FROM AUTHOR]
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