ROSH Gastrointestinal Practice Exam

In the case of a metal foreign body ingestion, what is the most appropriate management?

1. CT scan of the chest to evaluate the foreign body location

2. Emergent endoscopy

3. Glucagon

4. Observation

The correct answer is: Emergent endoscopy

In the case of metal foreign body ingestion, the most appropriate management involves emergent endoscopy. This approach is warranted because metal foreign bodies can pose significant risk for complications such as perforation, obstruction, or injury to the gastrointestinal tract. Immediate endoscopy allows for direct visualization and retrieval of the foreign body, minimizing potential risks and complications. While imaging, like a CT scan, may provide valuable information regarding the location of the foreign body, it does not offer a solution to the immediate need to remove it. Observation could be suitable for certain types of ingestions that are not hazardous; however, metal ingestions, particularly sharp objects or those that may cause perforation, require active intervention. Glucagon is primarily used in cases where there’s an esophageal foreign body, especially with an impact on motility, but in cases involving sharp or hazardous items, endoscopic intervention is critical to prevent severe complications.