Ishihara Yo, Ichita Chikamasa, Jinushi Ryuhei, Sasaki Akiko
Department of Gastroenterology Medicine Center Shonan Kamakura General Hospital Kanagawa Japan.
Department of Palliative Medicine International University of Health and Welfare Narita Hospital Chiba Japan.
DEN Open. 2024 Jul 15;5(1):e406. doi: 10.1002/deo2.406. eCollection 2025 Apr.
Blister pack (BP) ingestion poses serious risks, such as gastrointestinal perforation, and accurate localization by computed tomography (CT) is a common practice. However, while it has been reported in vitro that CT visibility varies with the material type of BPs, there have been no reports on this variability in clinical settings. In this study, we investigated the CT detection rates of different BPs in clinical settings.
This single-center retrospective study from 2010 to 2022 included patients who underwent endoscopic foreign body removal for BP ingestion. The patients were categorized into two groups for BP components, the polypropylene (PP) and the polyvinyl chloride (PVC)/polyvinylidene chloride (PVDC) groups. The primary outcome was the comparison of CT detection rates between the groups. We also evaluated whether the BPs contained tablets and analyzed their locations.
This study included 61 patients (15 in the PP group and 46 in the PVC/PVDC group). Detection rates were 97.8% for the PVC/PVDC group compared to 53.3% for the PP group, a significant difference ( < 0.01). No cases of BPs composed solely of PP were detected by CT. Blister packs were most commonly found in the upper thoracic esophagus.
Even in a clinical setting, the detection rates of PVC and PVDC were higher than that of PP alone. Identifying PP without tablets has proven challenging in clinical. Considering the risk of perforation, these findings suggest that esophagogastroduodenoscopy may be necessary, even if CT detection is negative.
泡罩包装（BP）摄入会带来严重风险，如胃肠道穿孔，通过计算机断层扫描（CT）进行准确定位是常见做法。然而，虽然体外研究报道CT对BP的显影因BP材料类型而异，但临床环境中关于这种变异性尚无报道。在本研究中，我们调查了临床环境中不同BP的CT检出率。
这项2010年至2022年的单中心回顾性研究纳入了因摄入BP而接受内镜下异物取出术的患者。根据BP成分将患者分为两组，聚丙烯（PP）组和聚氯乙烯（PVC）/聚偏二氯乙烯（PVDC）组。主要结局是比较两组之间的CT检出率。我们还评估了BP是否包含片剂并分析了它们的位置。
本研究纳入61例患者（PP组15例，PVC/PVDC组46例）。PVC/PVDC组的检出率为97.8%，而PP组为53.3%，差异有统计学意义（<0.01）。CT未检测到仅由PP组成的BP病例。泡罩包装最常见于胸段上段食管。
即使在临床环境中，PVC和PVDC的检出率也高于单独的PP。在临床中，识别不含片剂的PP具有挑战性。考虑到穿孔风险，这些发现表明，即使CT检测为阴性，也可能需要进行食管胃十二指肠镜检查。
