Inpatient and Outpatient Management for Foreign Body Ingestion: A Retrospective Review in an Emergency Department of Hong Kong

Abstract

Objectives To evaluate the outcome of patients who presented to our accident and emergency department (AED) for foreign body (FB) ingestion, and were managed in inpatient or outpatient settings according to the departmental protocol. Methods It was a retrospective observational study of patients admitted to the AED of Kwong Wah Hospital for FB ingestion from 1st March to 30th June 2007. Patients without FB found by direct laryngoscopy were admitted for inpatient oesophagogastroduodenoscopy (OGD) if they were under 12 years old, had significant symptoms with haematemesis, vomiting more than twice, swallowed FB other than fish bone or had FB seen on cervical X-ray, according to the departmental protocol. Patients without the above criteria were discharged for outpatient OGD. Demographic data, clinical information, OGD findings and outcomes, including complication rate and re-attendance rate, were studied and compared. Results There were 152 patients in this study; 71 of them were admitted for inpatient OGD and 81 were discharged for outpatient OGD. The mean age of the inpatient group was 46.34 years and that of the outpatient group 51.08. The mean day of impaction was 1.39 days for the inpatient group and 1.25 days for the outpatient group respectively. OGD was done for 59 outpatients and 17 of them were found to have FB. OGD was done for 35 inpatients and 23 of them were found to have FB. Fish bones were the commonest FB detected. One patient of the inpatient group developed complication and one patient re-attended within one month. Re-attendance was not found in the outpatient group. Conclusion Foreign body ingestions were commonly encountered in the AED. No statistically significant difference in complication rate and re-attendance rate between inpatients and outpatients was demonstrated in this study.