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Foreign body in colon — Clinical Guidelines

Overview

Foreign body ingestion leading to retention in the colon is a clinical scenario requiring prompt identification and management to prevent complications such as obstruction, perforation, or infection. 3

Diagnosis

Clinical Presentation: Abdominal pain, vomiting, altered bowel habits 3.

Imaging: Abdominal X-rays, CT scans can identify radiopaque foreign bodies 3.

Endoscopy: Colonoscopy is definitive for visualization and removal 3.

Grading: Adequacy of bowel preparation crucial for successful endoscopic visualization 2.

Management

Endoscopic Removal: Primary intervention for foreign body retrieval 3.

Bowel Preparation: Use of split-dose polyethylene glycol-electrolyte solution (6-L) to ensure adequate bowel cleansing 1.

Surgical Intervention: Reserved for cases where endoscopic removal fails or complications arise 3.

Special Populations

Patient Education: Emphasize importance of following instructions due to perceived patient understanding issues 3.

Comorbidities: No specific guidelines provided in abstracts; individualized care based on patient condition 3.

Key Recommendations

Employ split-dose bowel preparation protocols, such as 6-L polyethylene glycol-electrolyte solution, to enhance endoscopic visibility 1 (Evidence: Moderate).

Prioritize endoscopic removal as the primary method for foreign body extraction in the colon 3 (Evidence: Expert opinion).

Address patient education gaps regarding the importance of adhering to bowel preparation instructions to improve outcomes 3 (Evidence: Moderate).

References

1 Strauss AT, Yeh J, Martinez DA, Yenokyan G, Yoder J, Nehra R et al.. A patient-centered framework for health systems engineering in gastroenterology: improving inpatient colonoscopy bowel preparation. BMC gastroenterology 2021. link 2 Malhotra A, Shah N, Depasquale J, Baddoura W, Spira R, Rector T. Use of Bristol Stool Form Scale to predict the adequacy of bowel preparation - a prospective study. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2016. link 3 Hillyer GC, Basch CH, Basch CE, Lebwohl B, Kastrinos F, Insel BJ et al.. Gastroenterologists' perceived barriers to optimal pre-colonoscopy bowel preparation: results of a national survey. Journal of cancer education : the official journal of the American Association for Cancer Education 2012. link

Foreign body in colon