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• W4381113015 abstract "<h3>Introduction</h3> Deliberate foreign body ingestion (DFBI) can be seen amongst patients with psychiatric disorders; it is often recurrent and requires frequent medical attention. During the Coronavirus (COVID-19) pandemic, increased incidences of DFBI were noted across our acute hospital site, where dangerous objects (batteries, razors, toothbrushes) required retrieval via endoscopy under general anaesthetic (GA). The aim was to identify the timeframes and barriers in escalation and management of these high-risk patients from the point of presentation, with a view to highlighting new strategies to improve clinical outcomes and reduce prolonged admissions. <h3>Methods</h3> A retrospective observational study of patients presenting to an acute hospital with foreign body (FB) ingestion that required endoscopic retrieval under GA was undertaken. Data was collected from a 4-month period between November 2021 and February 2022 and reviewed the object(s) swallowed, timing of initial imaging, timing of endoscopy and clinical outcomes. This was analysed in conjunction with European Society of Gastroenterology (ESGE) guidelines to assess whether endoscopic intervention occurred within the appropriate timeframe. <h3>Results</h3> Over the 4-month period, 11 episodes of FB ingestion required endoscopic removal under GA, of which 10 episodes were secondary to DFBI. These 10 episodes were comprised of 4 individual patients, all with a documented mental health (MH) diagnosis. 82% of total episodes received initial imaging within 1-hour, all of which showed pre-pyloric FB. 18% of episodes were not referred to gastroenterology within a 12-hour period from the point of presentation and no gastroenterology referral was documented in 37% of episodes. Mean time to endoscopy was 20 hours (ranging from 4-hours – 38.5-hours) after initial presentation, with 18% of cases falling outside the endoscopy recommendation as per ESGE guidelines. FB was post-pyloric at the time of endoscopy in 27% of episodes, resulting in prolonged admissions for these patients. <h3>Conclusions</h3> Gastroenterology referral was frequently delayed or not documented. There was no recognised pathway for emergency staff to follow when patients presented with FB ingestion and ESGE guidance was not readily referred to. Multiple patients underwent a GA endoscopic procedure unnecessarily due to time delay between initial imaging and endoscopy. Patients with post-pyloric FB were then converted to surgical patients and required prolonged admissions. The outcomes from this study led to discussions surrounding systemic changes that may better support care for these patients including creating a standardised proforma, involving earlier gastroenterology referral and multidisciplinary team input including escalation to mental health inpatient centres." @default.
• W4381113015 created "2023-06-19" @default.
• W4381113015 creator A5032781775 @default.
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• W4381113015 date "2023-06-01" @default.
• W4381113015 modified "2023-09-27" @default.
• W4381113015 title "P239 Management of deliberate foreign body ingestion requiring endoscopic retrieval" @default.
• W4381113015 doi "https://doi.org/10.1136/gutjnl-2023-bsg.307" @default.
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