Yan Xin, Dai Guoping
Otolaryngology Department, Shaoxing People's Hospital, Shaoxing, Zhejiang, China.
Arch Acad Emerg Med. 2023 Sep 22;11(1):e65. doi: 10.22037/aaem.v11i1.2102. eCollection 2023.
Missed diagnosis of foreign bodies in esophagus occasionally results in adverse consequences for patients. This study aimed to analyze the clinical characteristics of esophageal foreign body missed diagnosis in 12 cases. Among the 12 patients, 7 didn't undergo esophagus-related examination due to mild pain; One case didn't report a clear history of swallowing foreign bodies. For one case, computed tomography (CT) examination had not reached the esophageal foreign body level. Two cases were missed diagnosis because the foreign bodies were too tiny to develop clearly on CT. One case showed foreign body in esophagus during initial CT examination, but after subsequent gastroscopy, no foreign body was found. Among the 12 patients, 7 had esophageal perforation, 1 of which developed a neck abscess, and 1 had peri-esophageal abscess. It seems that, if foreign bodies in the pharynx or esophagus are suspected and no foreign bodies are found in the laryngoscope, chest CT scan is necessary. It is best to perform examination of full-length esophagus and pharynx, because foreign bodies may exist in the post-cricoid region or the deep part of the pyriform sinus, especially in older cases with longer retention times.
食管异物的漏诊偶尔会给患者带来不良后果。本研究旨在分析12例食管异物漏诊的临床特征。在这12例患者中，7例因疼痛较轻未接受食管相关检查；1例未报告明确的吞食异物史。1例患者的计算机断层扫描（CT）检查未发现食管异物。2例因异物过小在CT上显示不清而漏诊。1例患者初次CT检查显示食管有异物，但后续胃镜检查未发现异物。12例患者中，7例发生食管穿孔，其中1例并发颈部脓肿，1例并发食管周围脓肿。似乎，如果怀疑有咽或食管异物，而喉镜检查未发现异物，则有必要进行胸部CT扫描。最好对食管和咽部进行全长检查，因为异物可能存在于环状软骨后区域或梨状窦深部，尤其是在滞留时间较长的老年患者中。
