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Complications and hospital stay after endoscopic retrieval of drug baggies in body stuffers: an observational prospective study

Authors
  • Shabani, Mahtab1
  • Kefayati, Marzieh2
  • Hassanian-Moghaddam, Hossein3, 4
  • Zamani, Nasim3, 4
  • McDonald, Rebecca5
  • 1 Private Gastreoentrologist, Tehran, Iran , Tehran (Iran)
  • 2 Shahid Beheshti University of Medical Sciences, Tehran, Iran , Tehran (Iran)
  • 3 Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran , Tehran (Iran)
  • 4 Shahid Beheshti University of Medical Sciences, South Karegar Street, Tehran, Iran , Tehran (Iran)
  • 5 King’s College London, Addiction Sciences, London, UK , London (United Kingdom)
Type
Published Article
Journal
Scientific Reports
Publisher
Springer Nature
Publication Date
Mar 08, 2021
Volume
11
Issue
1
Identifiers
DOI: 10.1038/s41598-021-84898-z
Source
Springer Nature
License
Green

Abstract

Body stuffers routinely receive conservative treatment, i.e. administration of the laxative polyethylene glycol for the passage of ingested drug baggies and observation. Endoscopic baggie removal may offer a safe alternative that could result in shorter hospitalization. We aimed to compare complications, hospital stay, and final outcome in body stuffers assigned to endoscopy versus conservative treatment. This is an observational prospective study of body stuffers presenting to a clinical toxicology center in Tehran (Iran) in 2016–2019, irrespective of the drug ingested. Eligible patients had baggies in their upper gastrointestinal tract and presented without severe poisoning. Patients received either endoscopy or conservative treatment, and clinical outcomes were compared between the groups. A total of 69 patients were enrolled, with a median age of 29 years (range 18–64), among whom 1 was female (2%). Eighteen and 51 patients were endoscopically and conservatively managed, respectively. Drugs most commonly ingested were heroin in endoscopy patients (8/18 cases; 44%) and methamphetamine in the conservative group (28/51 cases; 55%). Endoscopy patients had a shorter hospital stay (median 1.5 vs. 2 days, P = 0.018). In the conservative group, one patient died, and the rate of complications was significantly higher, with more patients experiencing side effects (OR = 1.4, 95% CI = 1.2, 1.7) and requiring intubation (OR = 1.3, 95% CI = 1.1, 1.5). Endoscopic retrieval was associated with fewer complications and shorter hospitalization. Endoscopy may be a safe treatment for body stuffers without severe poisoning on presentation.

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