Feng Shui, Peng Hong, Xie Hong, Bai Yunbo, Yin Jinshu
Department of Otolaryngology Head and Neck Surgery, Beijing Shijitan Hospital Affiliated to Capital Medical University, Beijing, China.
Ear Nose Throat J. 2020 May;99(4):251-258. doi: 10.1177/0145561319901033. Epub 2020 Jan 30.
To propose a management algorithm for adult patients with sharp-pointed esophageal foreign-body impaction (EFBI) who have rigid endoscopy (RE) indications and to conduct a retrospective analysis of their data.
All adult patients who received RE at the Department of Otorhinolaryngology in Beijing Shijitan Hospital between January 2017 and May 2019 were enrolled. The demographics, clinical characteristics, and management data were collected and analyzed.
A total of 130 patients were identified, 56.9% were female with median age 60 years. More than half (56.9%) of patients had foreign-body (FB) ingestion on holidays. The most frequent FBs were jujube pits (66.9%) and bones (23.8%). There is a significant female predominance in ingestion of jujube pits (65.5%, = .005). The most common symptoms were odynophagia (49.2%) and sore throat (47.7%). The majority (96.8%) of FB founded were lodged at upper esophagus. In all, 74 patients were categorized as having mild complications and 54 having significant complications. Time interval from ingestion to presentation longer than 15 hours was an independent risk factor for significant complications, while esophagogram with barium as a protective factor.
Long-time interval from ingestion to presentation will lead to high risk of significant complications. Computed tomography should be a prioritized imaging method for all patients suspected with EFBI, and multidisciplinary collaboration is recommended. Besides, mass education on eating habits is necessary.
为有硬式内镜检查（RE）指征的成人尖锐食管异物嵌顿（EFBI）患者提出一种管理算法，并对其数据进行回顾性分析。
纳入2017年1月至2019年5月在北京世纪坛医院耳鼻咽喉科接受RE的所有成年患者。收集并分析人口统计学、临床特征和管理数据。
共确定130例患者，56.9%为女性，中位年龄60岁。超过一半（56.9%）的患者在节假日吞食异物（FB）。最常见的FB是枣核（66.9%）和骨头（23.8%）。枣核吞食者中女性明显居多（65.5%，P = .005）。最常见的症状是吞咽痛（49.2%）和咽痛（47.7%）。发现的FB大多数（96.8%）嵌顿于食管上段。总共74例患者被归类为有轻度并发症，54例有严重并发症。从吞食到就诊的时间间隔超过15小时是严重并发症的独立危险因素，而钡剂食管造影是一个保护因素。
从吞食到就诊的时间间隔长会导致严重并发症的高风险。计算机断层扫描应作为所有疑似EFBI患者的优先成像方法，建议多学科协作。此外，有必要对饮食习惯进行大众教育。
