Eliashar R, Dano I, Dangoor E, Braverman I, Sichel J Y
Department of Otolaryngology-Head and Neck Surgery, Hadassah University Hospital, Jerusalem, Israel.
Ann Otol Rhinol Laryngol. 1999 Jul;108(7 Pt 1):708-10. doi: 10.1177/000348949910800717.
A prospective study was performed on 45 patients for an assessment of the use of computed tomography (CT) in the management of a suspected esophageal fish bone or chicken bone. All patients had negative findings on laryngoscopy; therefore, pharyngeal and hypopharyngeal foreign bodies were excluded from further consideration. The patients underwent radiographic examination with plain films and a cervical CT scan without contrast material. Patients with positive findings were taken to the operating room, where they underwent rigid esophagoscopy under general anesthesia, while those with negative findings remained for observation for 24 hours. Thirty CT scans were positive for an esophageal foreign body, and in all cases but 1, a foreign body was found during the operation. Fourteen of 15 patients with normal CT scan findings managed well with no further intervention. One patient with persistent complaints underwent esophagoscopy, but no foreign body was found. Our conclusion is therefore that CT is a simple and reliable method for diagnosing esophageal bone impaction and may reduce the rate of unnecessary esophagoscopies.
对45例患者进行了一项前瞻性研究，以评估计算机断层扫描（CT）在疑似食管鱼骨或鸡骨管理中的应用。所有患者喉镜检查结果均为阴性；因此，排除了咽和下咽异物，不再进一步考虑。患者接受了平片和无造影剂的颈部CT扫描的影像学检查。检查结果呈阳性的患者被送往手术室，在全身麻醉下接受硬式食管镜检查，而检查结果呈阴性的患者则留院观察24小时。30例CT扫描显示食管异物阳性，除1例以外，所有病例在手术中均发现了异物。15例CT扫描结果正常的患者中有14例无需进一步干预，病情得到妥善处理。1例持续有症状的患者接受了食管镜检查，但未发现异物。因此，我们的结论是，CT是诊断食管骨嵌塞的一种简单可靠的方法，并且可以降低不必要的食管镜检查率。
