Clinical features of esophageal foreign bodies difficult to remove by gastroscopy / 中华全科医师杂志

ABSTRACT

Objective To analyze the clinical features of esophageal foreign body(EFB) difficult to remove by gastroscopy.Methods The clinical data of 159 patients with EFBs treated in Renmin Hospital of Wuhan University from January 2013 to April 2017 were analyzed retrospectively.Among 159 cases,the EFBs were removed by gastroscopy in 101 cases(gastroscope group)and removed by non-gastroscope method in 58 cases (non-gastroscope group),including 42 cases removed by esophagoscopy and 16 cases by surgery.The general information of patients,the types of EFB,the condition of impaction,treatments and outcomes of the two groups were analyzed.Results There was no significant difference in age and sex between gastroscope group and non-gastroscope group (P ＞ 0.05).The food typeEFBs included fish bone (n =77),chicken bone (n =45),jujube seeds (n =15),food bolus (n =4);and the non-food type FEBs included spectecleslens (n =2),bottle cap (n =11),denture (n =5).More than one half of FBs were located in the upper esophagus:63.4％ (64/101) in gastroscope group and 66.7％ (28/42) in esophagoscope subgroup;however,EFBs were mostly located in the middle esophagus in surgery subgroup (62.5％,10/16).In gastroscope group and esophagoscope subgroup,the sharp EFBs of length-diameter ＞ 2 cm were rare(n =4,3.9％ and n =3,7.1％),but were common in the surgery group (n =9,56.3％).The EFBs were successfully removed in all patients without massive hemorrhage or death.In gastroscope group (n =101),93 cases had mucosal abrasion and bleeding,5 cases had mild active bleeding,and 1 case had esophageal fistula.In surgical removal (n =16) there were 4 cases of esophageal perforation and postoperative inflammation,3 cases of mediastinal inflammation and 2 cases of mediastinal abscess.Inesophagoscopic removal group (n =42),there were 2 cases of esophageal muscle layer abscess,1 case of esophageal fistula and 1 case of pulmonary infection.Conclusions The most common type of EFBs is of food source.Foreign bodies in the upper and middle segments of the esophagusare difficult to remove with gastroscopy.In case of a sharp foreign body embedded in the middle esophagus,surgical removal is preferred to avoid severe sequences.