Sundgren P C, Burnett A, Maly P V
Department of Diagnostic Radiology, University of Lund, Malmoe General Hospital, Sweden.
Ann Otol Rhinol Laryngol. 1994 Aug;103(8 Pt 1):628-31. doi: 10.1177/000348949410300809.
A retrospective study was performed on 42 consecutive patients to examine the value of radiography in the management of complaints of fishbone ingestion. All patients underwent an oral examination followed by radiographic examination with plain films, barium swallows, barium and water swallows, and an endoscopic examination. All radiographs were reviewed by two unbiased, experienced radiologists. Of the 7 cases with fishbone found at endoscopic examination, only two (29%) bones were seen by the primary radiologist and 5 (71%) by the reviewing radiologists. Except for one case in which all three radiologists detected a fishbone that passed during the examination, and thereby was not found on endoscopy, no fishbones were found at the radiographic examination that were not seen on the endoscopic examination. Thus, radiography added no valuable information but only delayed the endoscopic examination with ensuing removal of the foreign body, which had to be performed regardless of the outcome of the radiographic examination. Therefore, we suggest that patients with a short history of complaints of fishbone ingestion, ie, 48 hours or less, should first be evaluated with oral and endoscopic examination.
对42例连续患者进行了一项回顾性研究，以检查X线摄影在处理鱼骨吞食投诉中的价值。所有患者均接受了口腔检查，随后进行了普通X线片、吞钡、钡剂和水吞服的X线检查以及内镜检查。所有X线片均由两位公正、经验丰富的放射科医生进行复查。在内镜检查发现的7例有鱼骨的病例中，初诊放射科医生仅发现2例（29%）鱼骨，而复查放射科医生发现5例（71%）。除了1例所有三位放射科医生均检测到一根在检查过程中通过的鱼骨，因此在内镜检查中未发现外，在X线检查中未发现在内镜检查中未见的鱼骨。因此，X线摄影未提供有价值信息，只是延迟了内镜检查及随后的异物取出，而无论X线检查结果如何都必须进行异物取出。因此，我们建议，鱼骨吞食投诉病史较短（即48小时或更短）的患者应首先接受口腔和内镜检查评估。
