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Habitual Intentional Foreign Body Ingestion - A Literature Review.

Foreign body ingestion is a commonly reported clinical problem. There are no data to evaluate the prevalence of this phenomenon in Poland. In the United States the annual death rate due to foreign body ingestion is estimated at up to 1500-2700 (1). In 80% of cases foreign body ingestion is unintentional and reported in children (2). Among adults unintentional foreign body ingestion is reported most commonly in the elderly and alcohol-dependent patients (3). Some literature indicates that intentional foreign body ingestion among adults accounts for only 10% of all cases (4), there are however studies suggesting that intentional foreign body ingestion accounts for up to 92% of all cases of foreign body ingestion (5). Multiple retrospective studies confirm consistently that intentional foreign body ingestions are most commonly reported in patients with psychiatric disorders, mental impairment and in prison inmates (4-7). Considering all cases together, the majority of foreign bodies pass spontaneously, 10-20% require endoscopic intervention and only 1% are removed surgically (3). Intentional foreign body ingestion is associated with much more severe consequences, which require emergency medical intervention in up to 76% of patients and surgery in 28% of patients (8). Foreign body ingestion management depends on the characteristics of the ingested foreign body, such as: size, shape, presence of sharp edges, its location, time from ingestion, severity of clinical symptoms and development of potential complications (5). on the other hand the material the foreign body is made of determines the usefulness of diagnostic techniques (9, 10). This literature review presents the extent of intentional foreign body ingestion with regard to risk group characteristics, usefulness of imaging diagnostics, management options and prevention of recurrence.