Foreign body ingestion is a common reason for emergency visits in small animal practice. Depending on the nature of the foreign body and risk of gastrointestinal tract obstruction or perforation, various treatments may be recommended. Treatment options may include intensive monitoring, induction of emesis, and endoscopic or surgical removal. Treatment recommendations often are dependent on clinician experience and rarely supported by evidence in the peer-reviewed literature.
Retrospective studies of humans have found that 65% of ingested sharp-pointed objects pass without incidence,1 with perforation occurring in 15% to 35% of cases.2 On the basis of this information, the American Society for Gastrointestinal Endoscopy Practice Guidelines recommend endoscopic removal of all amendable ingested sharp objects in people.3 If retrieval is not possible by minimally invasive routes (eg, foreign body has passed into the jejunum) and the patient has no clinical signs associated with the foreign body, monitoring via examination of serial radiographs is recommended until passage of the foreign body.3 Surgical intervention is recommended in patients who develop clinical signs or patients in which the foreign body fails to advance after 3 days.3
The authors are not aware of similar veterinary consensus statements for nonobstructive foreign bodies, such as sewing needles. Case reports4–7 of sewing needle migration and a few retrospective studies8–10 that include descriptions of sewing needle foreign bodies have been published in the veterinary literature. To the authors’ knowledge, these reports do not include descriptions of the ability for sewing needles to pass through the gastrointestinal tract, incidence of perforation, or diagnostic and interventional options that will aid in clinical decision making. It is common to recommend endoscopic or surgical retrieval of a sewing needle foreign body from an animal, despite the lack of evidence in the veterinary literature to support such a recommendation. The purpose of the study reported here was to characterize the clinical signs, diagnostic evaluation, location of a sewing needle, frequency of perforation, definitive treatment, and outcome in dogs and cats with sewing needle foreign body ingestion.
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