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Ingested Foreign Bodies, Management of2019

Type: New Practice Management Guideline (PMG)
Category: Emergency General Surgery
Committee Liaison: Asanthi M. Ratnasekera, DO, FACS

Team leader(s)

The evaluation and management of patients who have ingested foreign bodies often results in consults to multiple medical and surgical services and different imaging studies. Additionally, EAST members report a significant amount of confusion over best practices when treating these patients. The American Society of Gastrointestinal Endoscopy (ASGE) Standards of Practice Committee wrote a practice management guideline (PMG) for this condition in 1995, with updates in 2003 and 2011, but their PMG does not hew to GRADE methodology. We propose writing a PMG for this issue that adheres to GRADE methodology in order to create a more transparent and rigorous set of recommendations. Potential areas of interest include: Which patients can be observed? Where is the best environment for patients to be observed – home, ED, inpatient, ICU? Which patients should be intervened upon? What’s the best way to intervene upon these patients - surgery vs. endoscopy? Do all foreign bodies need to be retrieved? Does it matter what the foreign body is? Does it matter where in the GI tract the foreign body is located? What modalities should be used to identify the type and location of the foreign body? Is there a role for serial imaging studies? Should children who’ve ingested foreign bodies be treated differently than adults who’ve ingested foreign bodies? If so, how?

Work Group Members
James Bardes, MD
Melissa M. Boltz, DO, MBA
Nikolay Bugaev, MD
Rondi Gelbard, MD
Ning Lu, MD
Esther S Tseng, MD
Zachary D. Warriner, MD
Alistair J Kent, MD, MPH
Gregory P. Schaefer, DO, FACS
Horacio Hojman, MD
Benjamin Johnson, MD

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