Foreign body ingestion is a common emergency. While endoscopy is the primary treatment, some cases require surgery. This study evaluated endoscopic outcomes and predictors of surgical intervention.

We performed a retrospective study (January 2019–July 2025) including all patients undergoing endoscopic removal of gastrointestinal foreign bodies. Demographic, clinical, radiologic, and endoscopic data were collected. Associations were analyzed using Chi-square and t-tests, and independent predictors of surgical intervention were identified through multivariate logistic regression.

A total of 63 patients were included (mean age 47.2 ± 13.1 years; range 18–82; sex ratio M/F = 0.9). Urban residence was documented in 80.9% of cases; 19% were incarcerated, and 11% had chronic psychotic disorders.The most frequent symptoms were epigastric pain (61.9%), dysphagia (38.1%), hypersalivation (25.4%), vomiting (14.3%), and respiratory symptoms (6.4%). Hematemesis occurred in two cases (3.2%). Almost all patients underwent preliminary abdominal radiography.The mean delay between ingestion and endoscopic intervention was 9.6 ± 7.9 hours (range 4–26). Foreign bodies included hard bread boluses (22.2%), plastic objects (20.6%), chicken bones (14.3%), poorly chewed food (14.3%), and sharp or bulky items (12.6%) such as lighters, metal clips, or dental prostheses.Endoscopic removal was performed via upper endoscopy in 95.2% of cases and rectosigmoidoscopy in 4.8%. Common extraction tools included rat-tooth forceps (31.7%) and snares (27%).Surgery was required in 6 patients (9.5%). In multivariate analysis, surgical intervention was independently associated with the presence of a sharp or bulky foreign body (OR 5.84; 95%CI 1.21–28.13; p = 0.028) and with an extraction delay exceeding 12 hours (OR 4.76; 95%CI 1.05–21.60; p = 0.042).

Endoscopy safely removes over 90% of gastrointestinal foreign bodies. Sharp or bulky objects and delays >12 hours independently predict the need for surgery. Early identification and timely endoscopic retrieval are key to reducing complications and improving outcomes.