Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th St, New York, NY, 10032, USA.
Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
Dig Dis Sci. 2020 Sep;65(9):2637-2643. doi: 10.1007/s10620-019-06033-3. Epub 2020 Jan 6.
As foreign body ingestion/food impaction is one of the less common indications for upper endoscopy in adults, few studies have investigated outcomes. We aimed to determine the distribution of ingested items warranting endoscopy and to identify factors associated with successful endoscopic retrieval.
We conducted a retrospective, cross-sectional study, identifying all endoscopies performed between June 2006 and June 2018 for foreign body ingestion or food impaction. We performed univariate and multivariate analyses to identify variables associated with endoscopic foreign body visualization and successful removal from the mouth.
Of the 168 endoscopies identified, the ingested item was visualized in 131 (78%) and was removed from the mouth in 88 (52.4%). 6.5% of cases required surgery and 2.4% of cases had a perforation noted. The two most common foreign bodies were food boluses (51.2%) and bones (28.6%). Older patients were more likely to have their ingested foreign body visualized during endoscopy (age ≥ 70 compared to 18-29 adjusted odds ratio [aOR] 8.78; 95% CI 1.62-47.70) and more likely to have it removed from the mouth (aOR 5.57; 95% CI 1.34-22.85). Bones were less likely to be visualized on endoscopy (aOR 0.16; 95% CI 0.04-0.57) but not less likely to be removed successfully (aOR 0.85; 95% CI 0.42-1.72). Foreign bodies visible on radiography were more likely to be identified on endoscopy (aOR 9.07; 95% CI 2.71-30.37) and more likely to be successfully removed (aOR 2.82; 95% CI 1.26-6.32).
Factors such as age, radiographic visibility, and the suspected foreign body may affect the likelihood that it can be visualized and removed. Future studies should focus on further characterizing complications of foreign body ingestions and the types of patients and objects most at risk.
由于异物摄入/食物嵌塞是成人上消化道内镜检查的不常见指征之一，因此很少有研究调查其结果。我们旨在确定需要内镜检查的摄入物的分布，并确定与内镜下成功取出相关的因素。
我们进行了一项回顾性、横断面研究，确定了 2006 年 6 月至 2018 年 6 月期间因异物摄入或食物嵌塞而行内镜检查的所有病例。我们进行了单变量和多变量分析，以确定与内镜下异物可视化和从口腔中成功取出相关的变量。
在 168 例内镜检查中，131 例（78%）可见摄入物，88 例（52.4%）从口腔中取出。6.5%的病例需要手术，2.4%的病例出现穿孔。最常见的两种异物是食物团块（51.2%）和骨头（28.6%）。老年患者更有可能在内镜检查中观察到其摄入的异物（年龄≥70 岁与 18-29 岁相比，调整后的优势比[aOR]8.78；95%置信区间[CI]1.62-47.70），并且更有可能从口腔中取出（aOR 5.57；95% CI 1.34-22.85）。骨头在内镜下观察到的可能性较小（aOR 0.16；95% CI 0.04-0.57），但成功取出的可能性并无差异（aOR 0.85；95% CI 0.42-1.72）。放射影像学可见的异物更有可能在内镜下识别（aOR 9.07；95% CI 2.71-30.37），并更有可能成功取出（aOR 2.82；95% CI 1.26-6.32）。
年龄、放射影像学可见性和可疑异物等因素可能会影响其可视化和取出的可能性。未来的研究应重点进一步描述异物摄入的并发症以及最容易发生此类并发症的患者和物体类型。
