Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
Am J Emerg Med. 2013 Sep;31(9):1328-32. doi: 10.1016/j.ajem.2013.05.049. Epub 2013 Jul 27.
To investigate the relationship between early use of computed tomography (CT) and complications associated with esophageal foreign body impaction in adults.
A retrospective study was performed on 120 patients (63 females, 57 males, median age 50 years) with a history of foreign bodies. All had negative findings on clinical examination. All cases underwent unenhanced helical CT, and patients with positive findings underwent esophagoscopy within 6 hours. All patients were followed up postoperatively.
CT demonstrated 100% sensitivity, 92.6% specificity, 100% negative predictive value, and 97.9% positive predictive value. Esophageal foreign bodies were associated with a high incidence of complications in adults, and there was a significant difference in the incidence of complications between different durations of impaction (P < .01). In total, 37 patients presented with complications: 32 patients with grade I, 3 with grade II, 2 with grade III, and 0 with grade IV.
Esophageal foreign bodies were associated with a high incidence of complications in adults. CT could detect foreign bodies accurately in the early stages, and then FBs could be removed as early as possible, which may reduce the incidence of complications. Moreover, the great majority of complications were of lower grades. Thus, CT may be a useful first-line radiological tool for the early diagnosis of esophageal foreign bodies in adults.
研究成人食管异物嵌顿早期使用计算机断层扫描（CT）与并发症之间的关系。
对 120 例（女性 63 例，男性 57 例，中位年龄 50 岁）有异物史的患者进行回顾性研究。所有患者临床检查均未见异常。所有患者均行平扫螺旋 CT，阳性结果者 6 小时内行食管镜检查。所有患者术后均进行随访。
CT 显示的敏感性为 100%，特异性为 92.6%，阴性预测值为 100%，阳性预测值为 97.9%。食管异物在成人中并发症发生率较高，不同嵌顿时间的并发症发生率有显著差异（P<.01）。共有 37 例患者出现并发症：32 例为 I 级，3 例为 II 级，2 例为 III 级，0 例为 IV 级。
食管异物在成人中并发症发生率较高。CT 可早期准确检测异物，尽早取出异物，可能降低并发症发生率。而且，大多数并发症的严重程度较低。因此，CT 可能是成人食管异物早期诊断的一种有用的一线影像学工具。
