Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, 38 Bangdong-gil, Sacheon-myeon, Gangneung, Gangwon-do, 25440, Korea.
BMC Gastroenterol. 2021 Oct 19;21(1):385. doi: 10.1186/s12876-021-01959-3.
Ingested foreign objects frequently require emergency removal. This study aimed to investigate the clinical outcomes of endoscopic removal of foreign bodies from the upper gastrointestinal tract and the risk factors for adverse events.
Adults (> 18 years) who underwent endoscopic management of ingested foreign bodies at two centers, one inland and one on the coast, between January 2008 and December 2017 were eligible. Clinical characteristics and procedure-related outcomes were retrospectively reviewed. Patients were divided into two groups, based on whether the foreign bodies were sharp or blunt in shape.
A total of 853 patients aged 19-96 years were analyzed. Ingestion of fish bones was more common in the coastal area, whereas ingestion of food boluses was more common in the inland area. The duration of impaction ranged from 1 h to over 1 month and was significantly longer in patients who ingested blunt than sharp foreign bodies (15 vs. 5 h, p < 0.001). Most (98.9%) foreign bodies were successfully removed. Adverse events occurred in 31.2 % of patients, including ulcers (4.0%) and perforations (3.3 %). Multivariate analysis showed that age (odds ratio [OR] 1.015, p = 0.012), sharp foreign bodies (OR 5.133, p < 0.001), location in the esophagus (OR 2.723, p = 0.018), and duration of impaction (OR 1.431, p < 0.001) were factors associated with adverse events.
Early recognition and timely endoscopic removal of ingested foreign bodies, particularly in elderly patients and those with sharp foreign bodies, may improve clinical outcomes.
吞食异物后常需紧急取出。本研究旨在探讨内镜下取出上消化道异物的临床效果及不良事件的危险因素。
本研究纳入 2008 年 1 月至 2017 年 12 月在 2 个中心（一个内陆，一个沿海）接受内镜治疗的吞食异物的成年（>18 岁）患者。回顾性分析了患者的临床特征和与操作相关的结局。根据异物的形状（锐或钝）将患者分为两组。
共纳入 853 例年龄 19-96 岁的患者。沿海地区更常吞食鱼骨，内陆地区更常吞食食物团块。嵌顿时间 1 小时至 1 个月以上，吞食钝形异物的患者嵌顿时间明显长于吞食锐形异物（15 小时 vs. 5 小时，p<0.001）。大多数（98.9%）异物被成功取出。31.2%的患者发生不良事件，包括溃疡（4.0%）和穿孔（3.3%）。多变量分析显示，年龄（优势比 [OR] 1.015，p=0.012）、锐形异物（OR 5.133，p<0.001）、异物位于食管（OR 2.723，p=0.018）和嵌顿时间（OR 1.431，p<0.001）是与不良事件相关的因素。
早期识别和及时内镜下取出吞食的异物，特别是在老年患者和吞食锐形异物的患者中，可能改善临床结局。
