The characteristics and endoscopic management outcomes of upper gastrointestinal foreign body ingestion in Eastern China: A retrospective analysis

Background: Foreign body (FB) ingestion in the upper gastrointestinal (GI) tract is a common clinical emergency globally, with risk profiles influenced by local dietary practices.In Eastern China, ingestion of sharp-edged jujube seeds represents a unique epidemiological concern.This study aimed to characterize the clinical features, endoscopic outcomes, and complication profiles associated with upper GI FB ingestion in this regional population.Methods: A retrospective study was conducted involving 642 adult patients who underwent endoscopic evaluation for suspected upper GI FB ingestion at Qilu Hospital, Shandong University (2015-2023).Data on FB types, anatomical locations, demographics, procedural outcomes, and complications were analyzed.Complications were categorized by severity into minor (erosion), moderate (ulceration/bleeding), and major (perforation/infection). Statistical significance was established at P < 0.05.Results: Among the 642 patients, 514 (80.06%) had confirmed FB ingestion.Jujube seeds were the most common FB (n = 269; 52.33%), followed by fish bones (n = 74; 14.39%) and other animal bones (n = 68; 13.22%).The upper esophagus was the predominant location for FB lodgment (n = 374; 72.76%).Endoscopic removal was successful in all confirmed FB cases (100%).Complications occurred in 395 patients (76.84%), primarily minor (mucosal erosion, 43.8%) and moderate (ulceration/bleeding, 42.6%).Major complications (perforation/infection) accounted for 13.67%, aligning with international standards.Jujube seeds were associated with the highest complication rate (49.07%).Conclusion: Endoscopic intervention remains highly effective for FB removal from the upper GI tract.However, sharp-edged FBs such as jujube seeds carry a significant complication burden, underscoring the need for early intervention, risk stratification, and public health initiatives targeting modifiable dietary risk factors.