You Swallowed What?

Hospitals can spend millions of dollars removing foreign objects—pens, batteries, and even razor blades—intentionally swallowed by patients, according to the November issue of Clinical Gastroenterology and Hepatology.

These cases are unusual but costly for the hospitals that deal with them. Brian Huang et al. found that at Rhode Island Hospital, 305 medical interventions were performed to remove foreign objects from upper gastrointestinal tracts of 33 adults over an 8-year period. Hospital and physician costs came to more than $2 million. Of the patients treated, 79% were previously diagnosed with a psychiatric disorder.

The intentionally ingested objects included pens (23.6%), batteries (9.2%), knives (7.2%; 1 knife was 7 inches long), razor blades (6.9%), other metal objects (6.6%), pencils (6.2%), toothbrushes (5.9%), spoons (4.9%) and coins (4.2%). They were most commonly lodged in the stomach or esophagus and retrieved by endoscopy; endoscopic complications occurred in only 11 cases. Only 2 of the cases required surgical extraction to remove the object, and none of the procedures led to a death.

Medicare and Medicaid paid for the treatment in almost 80% of cases. Huang discusses the patients, treatment, and cost analysis of the study in a video abstract:

Intentional foreign body ingestion is poorly understood, difficult to treat, and consumes considerable physician time and hospital resources. In his video abstract, Huang says “There is a clear financial benefit to managing these patients on an outpatient setting…;” the group developed an algorithm to manage cases as streamlined, cost-effective care through the emergency room without compromising patient care or safety.

Serrated knife blade swallowed by patient with a psychiatric disorder, not diagnosed as having suicidal intent.

Read the article online:
Huang BL, Rich HG, Simundson SE, et al. Intentional swallowing of foreign bodies is a recurrent and costly problem that rarely causes endoscopy complications. Clin Gastroenterol and Hepatol 2010;8:941–946.

About Kristine Novak, PhD, Science Editor

Dr. Kristine Novak is the science editor for Gastroenterology and Clinical Gastroenterology and Hepatology, both published by the American Gastroenterological Association. She has worked as an editor at biomedical research journals and as a science writer for more than 12 years, covering advances in gastroenterology, hepatology, cancer, immunology, biotechnology, molecular genetics, and clinical trials. She has a PhD in cell biology and an interest in all areas of medical research.
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