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上消化道异物迁移——十年机构经验

Migrated Foreign Body of Upper Digestive Tract-A Ten-Year Institutional Experience.

作者信息

Sekar Raghul, Raja Kalaiarasi, Ganesan Sivaraman, Alexander Arun, Saxena Sunil Kumar

机构信息

Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605 006 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):5577-5583. doi: 10.1007/s12070-021-02890-5. Epub 2021 Oct 12.

Abstract

The ingested foreign body is one of the commonest emergencies encountered by otolaryngologists Depending on the shape and duration of impaction, a small number of foreign bodies (1-2%) can perforate the wall of the gastrointestinal Tract. A migrated foreign body may remain quiescent or cause life-threatening suppurative and vascular complications. Data were collected retrospectively from the hospital records in a tertiary care hospital in South India from 2010 to 2020. Fifteen patients diagnosed with migrated foreign body and who underwent neck exploration were included in the study. Demographic details, mode of presentation, clinical and radiological findings, rigid esophagoscopy findings, neck exploration techniques employed were noted. The mean age of the patients was 37.66 years. All patients had a history of dysphagia, odynophagia, and point tenderness. All the patients underwent a lateral neck radiograph, and it was positive in 12 patients (80%), while in 3 patients (20%), it was negative. All the patients had a positive finding in Contrast-Enhanced Computed Tomography. Esophagoscopy was done prior to neck exploration to identify the site of injury and the probable site of migration. All the patients underwent lateral neck exploration, and foreign body was removed. Migrated foreign body can cause significant morbidity and mortality if not diagnosed and managed early. Strong suspicion and a systematic approach are needed for the diagnosis and management.

摘要

摄入异物是耳鼻喉科医生遇到的最常见的紧急情况之一。根据异物嵌顿的形状和持续时间,少数异物(1%-2%)可穿透胃肠道壁。移位的异物可能保持静止状态,也可能导致危及生命的化脓性和血管并发症。我们回顾性收集了2010年至2020年印度南部一家三级护理医院的病历数据。本研究纳入了15例诊断为异物移位并接受颈部探查的患者。记录了患者的人口统计学细节、就诊方式、临床和影像学检查结果、硬质食管镜检查结果以及所采用的颈部探查技术。患者的平均年龄为37.66岁。所有患者均有吞咽困难、吞咽痛和压痛点病史。所有患者均进行了颈部侧位X线检查,其中12例(80%)结果为阳性,3例(2)结果为阴性。所有患者在增强计算机断层扫描中均有阳性发现。在进行颈部探查之前先进行食管镜检查,以确定损伤部位和可能的移位部位。所有患者均接受了颈部侧方探查并取出了异物。如果不及早诊断和处理,移位的异物可能会导致严重的发病率和死亡率。诊断和处理需要高度怀疑和系统的方法。

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Migrated Foreign Body of Upper Digestive Tract-A Ten-Year Institutional Experience.
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