Bekele Abebe
Department of Surgery, School of Medicine, Addis Ababa University, Ethiopia.
Int J Otolaryngol. 2014;2014:293603. doi: 10.1155/2014/293603. Epub 2014 Apr 15.
Introduction. Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges. The best method of removal of an esophageal and tracheobronchial FB is endoscopic guided extraction. Objective. To present our experience of the removal of aerodigestive FBs in adult Ethiopian patients using rigid endoscopes. Methods. A hospital-based prospective study, at Tikur Anbessa Referral and Teaching Hospital, from January 2011 to December 2012 (over two years). Results. A total of 32 patients (18 males and 14 females) with a mean age of 28.0 ± 12.74 years were treated for FB ingestion and aspiration at Tikur Anbessa Hospital. The FBs were impacted at the esophagus in 18 (56.2%) patients, at the pharynx in 7 (21.8%), and at the air way in 7 (21.8%) patients. Pieces of bones were the commonest objects found in the esophagus (17/18 of the cases) and the pharynx (4/7), while fractured tracheostomy tubes and needles were frequently seen in the air way (3/7 cases each). The foreign bodies were visible in plain radiographs of 26 (81.2%) patients. Successful extraction of FBs was achieved by using Mc gill forceps in 11 cases, rigid esophagoscopes in 9 patients, and bronchoscopes in 4 cases. Four cases required open surgery to remove the foreign bodies. Two complications (one pneumothorax and one esophageal perforation) occurred. All patients were discharged cured. Discussion and Recommendations. Aerodigestive FBs are not so rare in the hospital and timely diagnosis and removal of accidentally ingested and aspirated foreign body should be performed so as to avoid the potentially lethal complications associated. Rigid esophagoscopy requires general anesthesia and is associated with its own complications, but our experience and outcome of its use are encouraging.
引言。上消化道异物是发病和死亡的重要原因,带来诊断和治疗方面的挑战。取出食管和气管支气管异物的最佳方法是内镜引导下取出。目的。介绍我们使用硬式内镜为成年埃塞俄比亚患者取出上消化道异物的经验。方法。2011年1月至2012年12月(两年多时间)在提古瑞·安贝萨转诊和教学医院进行的一项基于医院的前瞻性研究。结果。提古瑞·安贝萨医院共治疗了32例因异物摄入和误吸的患者(18例男性和14例女性),平均年龄28.0 ± 12.74岁。异物嵌顿于食管的有18例(56.2%),咽部7例(21.8%),气道7例(21.8%)。食管(17/18例)和咽部(4/7)最常见的异物是骨头碎片,而气道中常见的是气管切开套管折断和针头(各3/7例)。26例(81.2%)患者的异物在X线平片中可见。11例使用麦吉尔钳成功取出异物,9例使用硬式食管镜,4例使用支气管镜。4例需要开腹手术取出异物。发生了2例并发症(1例气胸和1例食管穿孔)。所有患者均治愈出院。讨论与建议。上消化道异物在医院并不罕见,应及时诊断并取出意外摄入和误吸的异物,以避免相关潜在致命并发症。硬式食管镜检查需要全身麻醉且有其自身并发症,但我们使用它的经验和结果令人鼓舞。