Division of General and Foregut Surgery, Department of Biomedical Sciences for Health, University of Milan, IRCCS Policlinico San Donato.
Eur J Gastroenterol Hepatol. 2020 Jul;32(7):827-831. doi: 10.1097/MEG.0000000000001717.
Esophageal foreign bodies, including food bolus impaction, represent a common clinical problem. The prevalence of underlying esophageal disease depends on study design and degree of suspicion of a structural or functional esophageal abnormality. Aim of this study was to analyze factors associated with recurrent impaction.
The prospectively collected database at a University Hospital and Swallowing Center was reviewed from January 2012 to June 2019 to identify all patients admitted for esophageal foreign bodies. Patients who underwent an emergency endoscopic procedure represented the final study sample. Patient characteristics, including history of previous esophageal foreign bodies, and type of endoscopic procedure were collected.
Sixty-five patients, 41 males and 24 females with a median age of 59 years, underwent emergency endoscopy for esophageal foreign bodies during the study period. Food bolus was the most common foreign body (n = 43, 66%). Flexible endoscopy was successful in retrieving or pushing the foreign bodies in the stomach in 91% of patients. In 54% of patients, impaction was secondary to an underlying esophageal disorder, which was previously unrecognized in half of them. Recurrent impaction was more common in patients with esophageal disease (P < 0.011). Surgical therapy was required in 4 patients (6.1%).
Food bolus impaction is a common sentinel event in patients with underlying esophageal disease and is associated with recurrent impaction. Diagnostic endoscopy with biopsies should possibly be performed at the first episode of impaction. Patients with negative biopsies should undergo barium swallow study and high-resolution esophageal manometry.
食管异物，包括食物团块嵌顿，是一种常见的临床问题。潜在的食管疾病的患病率取决于研究设计和对结构性或功能性食管异常的怀疑程度。本研究的目的是分析与复发性嵌顿相关的因素。
回顾了 2012 年 1 月至 2019 年 6 月在一家大学医院和吞咽中心收集的前瞻性数据库，以确定所有因食管异物而住院的患者。接受紧急内镜检查的患者代表了最终的研究样本。收集了患者的特征，包括以前的食管异物史和内镜检查类型。
在研究期间，65 名患者（41 名男性和 24 名女性）因食管异物接受了紧急内镜检查，中位数年龄为 59 岁。最常见的异物是食物团块（n = 43，66%）。91%的患者通过软性内镜成功地将异物取出或推入胃内。在 54%的患者中，嵌顿是由先前未被识别的潜在食管疾病引起的。食管疾病患者更常发生复发性嵌顿（P < 0.011）。4 名患者（6.1%）需要手术治疗。
食物团块嵌顿是潜在食管疾病患者的常见首发事件，与复发性嵌顿有关。在首次嵌顿时，可能需要进行诊断性内镜检查和活检。对活检阴性的患者应进行钡餐检查和高分辨率食管测压检查。
