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Foreign body-intestinal canal angle guides management of ingested foreign bodies in the lower gastrointestinal tract

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Abstract

Background

Determining whether prompt surgery is required for patient with ingested foreign bodies is clinically important.

Purpose

To evaluate the potential value of computed tomography (CT) in guiding the selection of surgical treatment for patients with ingested foreign bodies in the lower gastrointestinal tract.

Methods

Between January 2014 and December 2023, we analyzed the data of 58 patients (median age: 65.4 years; range, 31–96 years) with ingested foreign bodies in the lower gastrointestinal tract who underwent CT examinations. Patients were treated either conservatively (35 cases) or surgically (23 cases). The angle between the long axis of the foreign body and the intestinal canal (FB-IC angle) was measured. CT findings and clinical variables were evaluated to identify potential indicators for surgical treatment through univariate and multivariate logistic regression analyses.

Results

Univariate analysis revealed the FB-IC angle (P = 0.002), presence of free peritoneal gas (P = 0.002), white blood cell count (P = 0.018), and neutrophil count (P = 0.007) as significant factors associated with surgical treatment. Multivariate analysis demonstrated that the FB-IC angle (odds ratio, 1.033; P = 0.045) and the presence of free peritoneal gas (odds ratio, 41.335; P = 0.002) are independent indicators for surgical management. The FB-IC angle showed an area under the receiver operating characteristic curve of 0.755, with a cutoff value of 51.25 degrees.

Conclusion

The FB-IC angle and presence of free peritoneal gas serve as potential predictive imaging markers for surgical intervention.

Graphical Abstract

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Funding

Supported by Suzhou Science and Technology for Youths for Promoting Health through Science and Education Project, No. KJXW2023064. Supported by Jiangsu Medical Vocational College Campus Collaborative Innovation Research Project, No. 20239604.

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Authors and Affiliations

  1. Department of Radiology, The Affiliated Zhangjiagang TCM Hospital of Yangzhou University, No. 77 Changan Road, Zhangjiagang, 215600, Jiangsu, China

    Lei Wu, **ao-Yu Chen, Dan Ji, Zhi-Guo Zhang & Xu-** Mao

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  1. Lei Wu
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  2. **ao-Yu Chen
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  3. Dan Ji
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  4. Zhi-Guo Zhang
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  5. Xu-** Mao
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Correspondence to Xu-** Mao.

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Wu, L., Chen, XY., Ji, D. et al. Foreign body-intestinal canal angle guides management of ingested foreign bodies in the lower gastrointestinal tract. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04404-7

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