What is the management for an ingested sharp object located in the duodenum?

In instances where a sharp object is ingested and located in the duodenum, endoscopic removal is indicated due to the significant risk of perforation. The duodenum is a relatively small and sensitive segment of the gastrointestinal tract, and sharp objects, such as knives or broken glass, can pose a high risk of tearing through the intestinal wall, which can lead to serious complications like peritonitis or internal bleeding.

Endoscopy allows for direct visualization and retrieval of the foreign object, making it a safe and effective option compared to other management approaches. Monitoring through daily X-rays may not provide the necessary intervention required to prevent complications, while observation until the object passes could lead to adverse outcomes due to the nature of the object. Surgical removal, although an option, is typically reserved for cases where endoscopic techniques fail or if there is clear evidence of perforation or significant obstruction. Thus, endoscopic removal is the best practice in managing sharp objects in the duodenum to mitigate risks effectively.