Approach to foreign body ingestion, food impaction, and caustic injury

Foreign body ingestion and food impaction are conditions that may require prompt endoscopic therapy. Although the majority of ingested foreign bodies will eventually pass through the gastrointestinal tract, early intervention is necessary in some cases to prevent complications and alleviate symptoms. Although complications from ingested foreign bodies and impacted food boluses are rare, they can be severe, including aspiration, perforation, obstruction, and fistula and stricture formation. In addition, caustic injury from ingestion of acid or alkali is a cause of significant morbidity and mortality, especially in children. Early recognition, timely endoscopic evaluation of the degree of injury, and prevention of life-threatening complications are critical in triaging patients for either supportive or more invasive surgical intervention. Herein, the prevalence, predisposing factors, clinical presentation, and initial management of these gastrointestinal emergencies are highlighted. Specific endoscopic tools and techniques in managing ingested foreign bodies and food impaction are reviewed in a separate chapter. Suggested algorithms for the management of foreign body ingestion and food impaction are outlined. This chapter includes supplementary videos.