Endoscopic management of foreign bodies in the upper gastrointestinal tract: Report on a series of 414 adult patients
Endoscopic management of foreign bodies in the upper gastrointestinal tract: Report on a series of 414 adult patients
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DOI：
10.1055/s-2001-16212
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发表时间：
2001-08-01
期刊：
影响因子：
9.3
通讯作者：
Balzano, A
中科院分区：
文献类型：
--
作者：
Mosca, S;Manes, G;Balzano, A
背景和研究目的：摄入异物是一种常见的事件。文献中很少有论文报告三级中心的经验和结局。本文报告了1995年5月至1999年12月收治的414例可疑异物患者的处理方法和结果。方法：对不透射线的异物进行颈部、胸部或腹部X线平片检查，为排除可疑穿孔，同时进行计算机断层扫描（CT）检查。所有患者都被要求提供知情同意书，但有3名患者拒绝。总是使用麻醉，清醒镇静（86.8%），或在患者耐受性差的情况下使用全身麻醉（13.2%）。所有患者均在入院后6小时内接受了内窥镜手术。结果：异物检出率为64.5%。几乎所有的都在食道中发现。异物的种类有很大的不同，但它们主要是食物团、骨头或软骨、假牙或鱼骨。在3名患者（1.1%）中，无法通过内窥镜取出位于颈段食管中的异物：所有这3名患者均需要手术。未观察到与内窥镜手术相关的并发症，但30.7%的患者有潜在的食管疾病，如狭窄。只有8例患者需要第二次内窥镜手术，由一个更有经验的endoscopicist.Conclusion：异物摄入是一个常见的原因，紧急内镜检查。内窥镜手术是一种成功的技术，几乎在所有情况下都可以取出异物，而没有严重的并发症。很少需要手术。
Background and Study Aims: Ingestion of foreign bodies is a common occurrence. Few papers in the literature report experience and outcome at tertiary centers. The aim of this paper is to report the management and the outcomes in 414 patients admitted for suspected ingestion of foreign body between May 1995 and December 1999.Methods: A plain radiographic film of the neck, chest or abdomen was obtained in the case of radiopaque objects, and in order to rule out suspected perforation: in such cases a computed tomography (CT) study was also performed. All patients were asked to give their informed consent, which was refused by three patients. Anesthesia was always used, either conscious sedation (86.8 %), or general anesthesia in the case of poor patient tolerance (13.2 %). All patients underwent an endoscopic procedure within six hours of admission. A flexible scope was used in all patients and a wide range of endoscopic devices was employed.Results: Foreign bodies were found in 64.5 % of our patients. Almost all were found in the esophagus. The types of foreign body were very different, but they were chiefly food boluses, bones or cartilages, dental prostheses or fish bones. In three patients (1.1 %) it was impossible to endoscopically remove the foreign body, which was located in the cervical esophagus: all these three patients required surgery. No complications relating to the endoscopic procedure were observed, but 30.7% of patients had an underlying esophageal disease, such as a stricture. Only eight patients required a second endoscopic procedure, performed by a more experienced endoscopist.Conclusion: Foreign body ingestion represents a frequent reason for emergency endoscopy. The endoscopic procedure is a successful technique which allows the removal of the foreign bodies in almost all cases without significant complications. Surgery is rarely required.