Cao Li, Chen Nianjun, Chen Yao, Zhang Min, Guo Qiaozhen, Chen Qian, Cheng Bin
Department of Gastroenterology and Hepatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore). 2018 Jun;97(26):e11275. doi: 10.1097/MD.0000000000011275.
Ingested esophageal foreign bodies are commonly seen in adult population. In very few instances, esophageal foreign body may pass through the mucosal surface, re-epithelialize or migrate into surrounding soft tissues.
A 55-year-old Chinese male was admitted to our hospital with a 10-day history chest and upper abdominal pain without dysphasia, cough or other symptoms.
We initially suspected chronic gastritis, and thoracic computed tomography and endoscopy ultrasonography (EUS) were used to identify a fish bone completely embedded within the lower esophageal wall.
Under the EUS-guidance, we marked the foreign body using methylene blue with saline solution, which was followed by successful thoracoscopy and surgical removed of the foreign body.
The patient recovered well and was discharged 1 week postoperatively. One month postoperatively, the patient was symptom free and the chest wound was complete healed.
Our case showed that computed tomography is necessary to diagnose the esophageal foreign body, and EUS may help confirm the position of foreign body, especially those embedded in the esophageal submucosa. We advocate necessary surgery at the first accurate diagnosis in patient with esophageal foreign body when endoscopy is not possible.
食管异物摄入在成人中较为常见。在极少数情况下，食管异物可能穿过黏膜表面、重新上皮化或迁移至周围软组织。
一名55岁中国男性因胸部和上腹部疼痛10天入院，无吞咽困难、咳嗽或其他症状。
我们最初怀疑为慢性胃炎，随后通过胸部计算机断层扫描和内镜超声检查（EUS）发现一根鱼骨完全嵌入食管下壁。
在EUS引导下，我们用亚甲蓝生理盐水溶液标记异物，随后成功进行胸腔镜检查并手术取出异物。
患者恢复良好，术后1周出院。术后1个月，患者无症状，胸部伤口完全愈合。
我们的病例表明，计算机断层扫描对于诊断食管异物是必要的，EUS有助于确定异物位置，尤其是那些嵌入食管黏膜下层的异物。我们主张在无法进行内镜检查时，对食管异物患者一旦准确诊断就应进行必要的手术。
