Celik Sezai, Aydemir Bülent, Tanrıkulu Handan, Okay Tamer, Doğusoy Ilgaz
Department of Thoracic Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2013 May;19(3):229-34. doi: 10.5505/tjtes.2013.22687.
Esophageal foreign object ingestion is frequently seen in all ages. Failure to treat can cause serious complications such as esophageal perforation. The aims of this study were to characterize the clinical features related to foreign objects in the esophagus and to analyze the results of commonly used methods for their removal.
We analyzed 20 years of records from Siyami Ersek Hospital, Istanbul and identified 512 cases of foreign objects enlodged in the esophagus.
In pediatric patients, the majority were aged between 2-5 years (34.4%), while in adult patients, the majority were above 55 years (38.7%). Coins were the most common foreign object detected in children (68.8%), whereas meat impaction was most common in adults (87.4%). The most common location of the foreign object was the cervical esophagus in children (78.2%), and the thoracic esophagus in adults (66.4%). In 30.8% of adults, there was esophageal or systemic disease. Objects were removed with a Magill clamp in 48.3% of children. Rigid endoscopy was the main treatment in adult patients. Perforation due to endoscopy developed in three patients. Surgical repair was performed on these patients but all died due to mediastinitis.
Underlying esophageal or systemic diseases may predispose adults to foreign object ingestion in the esophagus. Improved endoscopic experience and clinical management of thoracic surgeons led to reduced morbidity and mortality in recent years.
食管异物吞食在各年龄段都很常见。未能及时治疗可能导致严重并发症，如食管穿孔。本研究的目的是描述与食管异物相关的临床特征，并分析常用取出方法的效果。
我们分析了伊斯坦布尔锡亚米·埃尔塞克医院20年的记录，确定了512例食管异物嵌顿病例。
在儿科患者中，大多数年龄在2至5岁之间（34.4%），而在成年患者中，大多数年龄在55岁以上（38.7%）。硬币是儿童中最常见的异物（68.8%），而肉块嵌塞在成人中最常见（87.4%）。异物最常见的位置在儿童中是颈段食管（78.2%），在成人中是胸段食管（66.4%）。在30.8%的成人中，存在食管或全身性疾病。48.3%的儿童异物通过Magill钳取出。硬质内镜检查是成年患者的主要治疗方法。三名患者因内镜检查导致穿孔。对这些患者进行了手术修复，但均因纵隔炎死亡。
潜在的食管或全身性疾病可能使成年人易发生食管异物吞食。近年来，内镜经验的改善和胸外科医生的临床管理导致发病率和死亡率降低。
