Das Aparna, Ramasamy Karthikeyan, Thangavel Saranya, Hansdah Rashmi, Alexander Arun, Saxena Sunil Kumar
Department of ENT, JIPMER, Pondicherry, India.
Eur Arch Otorhinolaryngol. 2022 Feb;279(2):955-959. doi: 10.1007/s00405-021-06833-2. Epub 2021 Apr 30.
Foreign body oesophagus is a commonly seen emergency in ENT. It is seen both in children and adults. When sharp bony foreign bodies such as chicken, fish, and mutton bone gets impacted in the oesophagus, it predisposes the patient to various complications. The foreign body can migrate extraluminally with time and cause retropharyngeal abscess.
Retrospective study over a period of 6 months from November 2019 to April 2020 of patients with foreign body oesophagus. We came across 20 patients with oesophageal foreign bodies and five of them had associated retropharyngeal abscess. Rigid esophagoscopy with foreign body removal and internal drainage of pus through the oesophageal rent followed by conservative management with intravenous antibiotics based on culture and sensitivity was done.
Patients improved drastically as the pus drained into the oesophagus via the rent in the posterior oesophageal wall and did not require an external incision and drainage. They were discharged in a week.
Removal of partial extraluminally migrated foreign body oesophagus and internal drainage of the abscess followed by nasogastric feeds till the rent resolves and intravenous pus culture-sensitive antibiotics fastens patient recovery and reduces the morbidity associated with external incision and drainage and oesophageal rent repair.
食管异物是耳鼻喉科常见的急症。儿童和成人均可发生。当鸡骨、鱼骨和羊骨等尖锐骨质异物嵌顿于食管时，患者易出现各种并发症。随着时间推移，异物可向管腔外移位并导致咽后脓肿。
对2019年11月至2020年4月期间6个月内的食管异物患者进行回顾性研究。我们共遇到20例食管异物患者，其中5例伴有咽后脓肿。通过硬式食管镜取出异物，并经食管裂口进行脓液内引流，随后根据培养和药敏结果静脉应用抗生素进行保守治疗。
随着脓液经食管后壁的裂口排入食管，患者病情显著改善，无需进行外部切开引流。他们在一周内出院。
取出部分向管腔外移位的食管异物并对脓肿进行内引流，随后进行鼻饲直至裂口愈合，同时静脉应用对脓液培养敏感的抗生素，可加快患者康复，降低与外部切开引流及食管裂口修复相关的发病率。
