Sink Jacquelyn R, Kitsko Dennis J, Mehta Deepak K, Georg Matthew W, Simons Jeffrey P
Department of Internal Medicine, University of Pittsburgh School of Medicine; UPMC MOntefiore Hospital N-715; Pittsburgh, Pennsylvania, USA.
Department of Otolaryngology; Children's Hospital of Pittsburgh of UPMC; University of Pittsburgh School of Medicine; Pittsburgh, Pennsylvania, USA.
Ann Otol Rhinol Laryngol. 2016 Apr;125(4):342-50. doi: 10.1177/0003489415611128. Epub 2015 Oct 16.
(1) To describe clinical and radiologic findings in patients with esophageal foreign bodies. (2) To examine the sensitivity and specificity of history, physical examination, and radiologic studies in children with suspected foreign body ingestion.
A retrospective cohort study was performed evaluating all children who underwent esophagoscopy for suspected foreign body ingestion at our institution from 2006 to 2013.
Five hundred forty-three patients were included (54% male). Average age was 4.7 years (SD = 4.1 years). Foreign bodies were identified on esophagoscopy in 497 cases (92%). Ingestion was witnessed in 23% of cases. Most common presenting symptoms were choking/gagging (49%), vomiting (47%), and dysphagia/odynophagia (42%). Most patients with foreign bodies had a normal exam (76%). Most foreign bodies were radiopaque (83%). In 59% of patients with normal chest radiographs, a foreign body was present. Sensitivity and specificity of 1 or more findings on history, physical examination, and imaging were 99% and 0%, 21% and 76%, and 83% and 100%, respectively.
Most patients with esophageal foreign bodies are symptomatic. Although many patients will have a normal physical examination, an abnormal exam should increase suspicion for a foreign body. Most esophageal foreign bodies are radiopaque, but a normal chest radiograph cannot rule out a foreign body.
（1）描述食管异物患者的临床和影像学表现。（2）检查病史、体格检查及影像学检查对疑似异物吞食儿童的敏感性和特异性。
进行一项回顾性队列研究，评估2006年至2013年在本机构因疑似异物吞食而接受食管镜检查的所有儿童。
共纳入543例患者（54%为男性）。平均年龄4.7岁（标准差 = 4.1岁）。497例（92%）经食管镜检查发现有异物。23%的病例有异物吞食目击史。最常见的症状为呛噎/作呕（49%）、呕吐（47%）及吞咽困难/吞咽痛（42%）。大多数有异物的患者体格检查正常（76%）。大多数异物不透X线（83%）。胸部X线片正常的患者中，59%存在异物。病史、体格检查及影像学检查中一项或多项发现的敏感性和特异性分别为99%和0%、21%和76%、83%和100%。
大多数食管异物患者有症状。虽然许多患者体格检查正常，但检查异常应增加对异物的怀疑。大多数食管异物不透X线，但胸部X线片正常不能排除异物。
