Geraci Girolamo, Sciume' Carmelo, Di Carlo Giovanni, Picciurro Antonino, Modica Giuseppe
Operative Unit of General and Thoracic Surgery, University of Palermo, Palermo, Italy.
BMC Emerg Med. 2016 Nov 4;16(1):42. doi: 10.1186/s12873-016-0104-3.
Ingestion of foreign bodies and food impaction represent the second most common endoscopic emergency after bleeding. The aim of this paper is to report the management and the outcomes in 67 patients admitted for suspected ingestion of foreign body between December 2012 and December 2014.
This retrospective study was conducted at Palermo University Hospitals, Italy, over a 2-year period. We reviewed patients' database (age, sex, type of foreign body and its anatomical location, treatments, and outcomes as complications, success rates, and mortalities).
Foreign bodies were found in all of our 67 patients. Almost all were found in the stomach and lower esophagus (77 %). The types of foreign body were very different, but they were chiefly meat boluses, fishbones or cartilages, button battery and dental prostheses. In all patients it was possible to endoscopically remove the foreign body. Complications related to the endoscopic procedure were unfrequent (about 7 %) and have been treated conservatively. 5.9 % of patients had previous esophageal or laryngeal surgery, and 8.9 % had an underlying esophageal disease, such as a narrowing, dismotility or achalasia.
Our experience with foreign bodies and food impaction emphasizes the importance of endoscopic approach and removal, simple and secure when performed by experienced hands and under conscious sedation in most cases. High success rates, lower incidence of minor complications, reduction of the need of surgery and reduced hospitalization time are the strengths of the endoscopic approach.
吞食异物和食物嵌塞是继出血之后第二常见的内镜急诊。本文旨在报告2012年12月至2014年12月期间因疑似吞食异物入院的67例患者的治疗情况及结果。
这项回顾性研究在意大利巴勒莫大学医院进行，为期2年。我们查阅了患者数据库（年龄、性别、异物类型及其解剖位置、治疗方法以及作为并发症、成功率和死亡率的结果）。
我们的67例患者均发现有异物。几乎所有异物都位于胃和食管下段（77%）。异物类型差异很大，但主要是肉块、鱼骨或软骨、纽扣电池和假牙。所有患者均可行内镜下取出异物。与内镜操作相关的并发症并不常见（约7%），且已进行保守治疗。5.9%的患者既往有食管或喉部手术史，8.9%的患者有潜在的食管疾病，如狭窄、运动障碍或贲门失弛缓症。
我们处理异物和食物嵌塞的经验强调了内镜检查和取出的重要性，在大多数情况下，由经验丰富的人员在清醒镇静下操作时，内镜检查和取出简单且安全。高成功率、较低的轻微并发症发生率、减少手术需求以及缩短住院时间是内镜治疗方法的优势。
