Mosca S, Manes G, Martino R, Amitrano L, Bottino V, Bove A, Camera A, De Nucci C, Di Costanzo G, Guardascione M, Lampasi F, Picascia S, Picciotto F P, Riccio E, Rocco V P, Uomo G, Balzano A
Dept. of Gastroenterology, A. Cardarelli Hospital, Via Monte di Dio, 74, 80132 Naples, Italy.
Endoscopy. 2001 Aug;33(8):692-6. doi: 10.1055/s-2001-16212.
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.
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.
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.
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.
吞食异物是一种常见现象。文献中很少有论文报道三级医疗中心处理此类情况的经验及结果。本文旨在报告1995年5月至1999年12月期间因疑似吞食异物入院的414例患者的治疗及结果。
对于不透射线的异物，拍摄颈部、胸部或腹部的X线平片，为排除疑似穿孔情况，此类病例还需进行计算机断层扫描（CT）检查。所有患者均被要求签署知情同意书，有3例患者拒绝。始终采用麻醉，86.8%的患者采用清醒镇静，13.2%患者因耐受性差采用全身麻醉。所有患者在入院6小时内接受内镜检查。所有患者均使用可弯曲内镜，并采用了多种内镜设备。
64.5%的患者发现有异物。几乎所有异物都位于食管。异物类型差异很大，但主要是食物团块、骨头或软骨、假牙或鱼骨。3例（1.1%）位于颈段食管的异物无法通过内镜取出，这3例患者均需手术治疗。未观察到与内镜操作相关的并发症，但30.7%的患者有潜在食管疾病，如食管狭窄。仅8例患者需要由经验更丰富的内镜医师进行第二次内镜检查。
吞食异物是急诊内镜检查的常见原因。内镜检查是一种成功的技术，几乎在所有病例中都能取出异物且无明显并发症。很少需要手术治疗。
