Volpi A, Laforgia R, Lozito C, Panebianco A, Punzo C, Ialongo P, Carbotta G, Sederino M G, Minafra M, Paterno A, Palasciano N
G Chir. 2017 Mar-Apr;38(2):80-83. doi: 10.11138/gchir/2017.38.2.080.
We studied 21 episodes of ingestion of foreign bodies (IFO) among 15 prisoners.
Rectrospective research in pts admitted to emergency from June 2005 to May 2105. Ingestion, management and pts outcome were analyzed. Prisoners with previous esophagogastroduodenal disease were excluded.
All pts were males and ingestions were intentional. Esophagogastroduoduenoscopy (EGDS) was performed in 10pts (8 cases with successful removal, 1 case we did not find anything e 1 of unsuccessful EGDS, that required emergency surgey. 9 pts rejected EGDS: in 2 pts were not necessary.Among the 9 pts that rejected EGDS, 5 discharged voluntary. No mortality neither morbidity. Only 1 pt required surgery.The IFO were 34 (23 sharp, 6 flat,5 indefined). We did not observe any food bolus impaction. Multiple ingestion was found in 11 pts. Recurrent episodes were found in 4 pts.
Almost all episodes can be treated conservatively with observation and endoscopy but the management of this pts has a financial impact on healthcare cost and on security costs. Prevention strategies are important to predict patient group at high risk for recurrent IFO.
我们研究了15名囚犯中的21例异物摄入事件。
对2005年6月至2015年5月入住急诊科的患者进行回顾性研究。分析了异物摄入情况、处理方式及患者结局。排除既往有食管胃十二指肠疾病的囚犯。
所有患者均为男性,异物摄入均为故意行为。10例患者接受了食管胃十二指肠镜检查(EGDS)(8例成功取出异物,1例未发现异物,1例EGDS未成功,需紧急手术)。9例患者拒绝接受EGDS检查:2例无需检查。在拒绝接受EGDS检查的9例患者中,5例自愿出院。无死亡及发病情况。仅1例患者需要手术。异物有34个(23个尖锐物品,6个扁平物品,5个不明物品)。未观察到任何食物团块嵌塞。11例患者存在多次摄入异物情况。4例患者有反复发生的情况。
几乎所有事件都可通过观察和内镜检查进行保守治疗,但对这些患者的处理会对医疗费用和安保成本产生经济影响。预防策略对于预测异物反复摄入的高危患者群体很重要。