Remsen K, Lawson W, Biller H F, Som M L
Ann Otol Rhinol Laryngol Suppl. 1983 Jul-Aug;105:32-44. doi: 10.1177/00034894830920s403.
Only a small number of ingested foreign bodies perforate the esophagus and even a smaller fraction migrate extraluminally. Four such penetrating and migrating foreign bodies of the upper aerodigestive tract are presented. Review of the literature revealed 321 cases of penetrating ingested foreign bodies, of which 252 remained intraluminal and 43 were found extraluminally, with the status of the remainder indeterminate. Analysis revealed that an intraluminal penetrating foreign body carried a higher overall mortality than one that migrated extraluminally. Although intraluminal and extraluminal penetrating foreign bodies may remain quiescent for years before presenting a complication, no correlation existed between mortality and the duration of the foreign bodies' retention. The greatest mortality was seen with vascular complications followed by diffuse and local suppurative processes. The overall mortality was significantly reduced in the post-antibiotic era.
仅有一小部分摄入的异物会穿透食管，而迁移至管腔外的异物比例更小。本文报告了4例上消化道穿透性并迁移性异物。文献回顾显示，共有321例摄入性穿透性异物，其中252例仍位于管腔内，43例位于管腔外，其余病例情况不明。分析表明，管腔内穿透性异物的总体死亡率高于迁移至管腔外的异物。尽管管腔内和管腔外穿透性异物在出现并发症前可能数年都保持静止状态，但死亡率与异物留存时间并无关联。血管并发症导致的死亡率最高，其次是弥漫性和局部化脓性病变。抗生素时代后，总体死亡率显著降低。
