Management of Gastrointestinal Foreign bodies using Flexible Endoscopy: an experience from Addis Ababa, Ethiopia

Background: Foreign body (FB) ingestion is a common surgical emergency that often requires prompt intervention before complications occur. A total of 25 patients with a history of accidental foreign body ingestion were treated in our medical center. The aim of this study is to present our experience of gastrointestinal foreign body extractions under light conscious sedation using flexible video endoscopes in children and adults at Adera Medical center in Addis Ababa, Ethiopia. Methods: A total of 25 patients were admitted to Adera Medical center for removal of ingested FB using flexible video endoscopes. The patients were observed and followed up for anticipated complications and discharged after stabilization with analgesics and counseling. History of FB ingestion, dysphagia, odynophagia, drooling of saliva, vomiting, and vague sensation of FB were used as diagnostic criteria. Lateral and PA neck, chest, and abdominal plain x-rays were also taken as appropriate for diagnosis as well as follow up of passage of disimpacted FB per rectum. After informed consent was obtained, light sedation and anesthesia were provided using IV diazepam, and oral xylocaline spray, flexible Esophagogastroduodenoscopy (EGD) was performed using standard procedure. Once identified, the FB was removed by FB grasper/forceps. Results: A total of 25 patients, 10 children &15 adults) with a mean age of 14.7 years (range 2 – 34) were treated for FB ingestion upon presentation to the Adera Medical Center. The mid intra-thoracic esophagus was the commonest site of FB impaction followed by the stomach. Dysphagia, odynophagia, and drooling of saliva were the commonest presenting symptoms. Hair pins and pieces of bone were the commonest FB encountered. Nearly all (98%) presented within 24 hours of accidental FB ingestion and all of the FBs were removed successfully without any complication. Conclusion: Flexible Endoscopy is a very safe and efficient method of timely diagnosis and removal of ingested FBs in children and adults in trained hands to prevent life threatening complications. Our finding is similar to other international reports