Intestinal Foreign Bodies - Symptoms

In most cases, patients themselves seek medical attention about a swallowed foreign body, without any complaints, sometimes they indicate a feeling of "scratching" in the throat behind the breastbone (in the esophagus), which occurs or intensifies when swallowing; in some cases, spasmodic pain in the abdomen appears. Often, these unpleasant sensations are caused by slight trauma to the mucous membrane of the pharynx or esophagus by a poorly chewed piece of dense hard food. The patient is frightened and believes that he swallowed pieces of beef, chicken or fish bone while eating. However, the studies conducted do not reveal a foreign body in the digestive tract.

It is important to keep in mind that if a swallowed foreign body is not retained in the esophagus and stomach, then most often by the time the patient gets to the doctor and is examined by X-ray (usually 3-4 hours or more after swallowing), the foreign body is already in the small intestine or cecum.

In other cases, severe abdominal pain is noted, and the body temperature rises. The doctor must carefully question the patient about the nature of the suspected foreign body, the circumstances under which it was swallowed, examine the pharynx, palpate the neck, abdomen, trying to detect areas of pain, tension in the muscles of the anterior abdominal wall, and even in some cases palpate the foreign body if it is large enough, and the patient's abdominal wall is not tense and there is no large subcutaneous fat layer. Then, a methodical X-ray examination is carried out: first, the pharynx and esophagus are examined, then the stomach, duodenum, and other parts.

In a favorable course, which is observed in most cases, the foreign body of the intestine comes out during defecation, and it can often be found in the feces. In cases where the foreign body is retained in the intestine, especially if it has sharp edges or a point at the end, various complications are possible. They can be conditionally divided into early ones, which occur within the next few hours or several days after swallowing the foreign body, and late ones, which appear after many days, weeks, months, and in some cases even years.

One of the relatively rare immediate severe complications is perforation of the intestinal wall by a foreign body with the development of peritonitis or, more often, an abscess isolated by adhesions. In some cases, a foreign body that has penetrated the intestinal wall is encapsulated without developing an abscess. Its further fate may be different: either the foreign body remains encapsulated for a long time, without causing significant disturbances in the patient's condition, or, more often, abdominal pain develops, the general condition is disturbed, and the temperature periodically rises. Subsequently, the abscess may open into the intestine or out through the abdominal wall. In the case of foreign bodies that have caused perforation of the wall of the cecum or rectum with the development of a limited abscess, penetration into the bladder and vagina, as well as the formation of anal fistulas, are possible.

Among other complications of foreign bodies entering the intestine, one should keep in mind the possibility of intestinal bleeding, which, however, is very rarely profuse. Large foreign bodies can cause obstructive intestinal obstruction (large fruit pits, large conglomerates of roundworms, large gallstones entering the intestine when a fistula forms between the gallbladder and the intestine, which is observed quite rarely in purulent calculous cholecystitis).

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