Derowe A, Ophir D
Department of Otolaryngology-Head and Neck Surgery, Meir Hospital, Kfar-Saba, Israel.
Am J Otolaryngol. 1994 Jan-Feb;15(1):41-5. doi: 10.1016/0196-0709(94)90039-6.
Suspected impaction of esophageal foreign bodies may at times pose a diagnostic problem as to the decision to perform esophagoscopy. It is not unusual to perform a rigid esophagoscopy following a diagnostic work-up for an impacted foreign body and not to find one. This study attempts to delineate the clinical situations where negative esophagoscopies are more likely to occur.
In a retrospective analysis of 98 rigid esophagoscopies performed for suspected foreign bodies in our department, an attempt was made to delineate the clinical and radiologic findings characteristic of the patients who had no foreign body at esophagoscopy compared with the patients in whom a foreign body was found.
Negative esophagoscopies were associated with suspected bone (mostly fish) impaction in 20 of the 22 negative esophagoscopies. Other parameters associated with negative findings were prolonged duration of symptoms and a positive finding at the physical examination. In suspected bone impaction, barium studies and neck x-rays were not helpful in determining the presence of a foreign body.
Clinical history is the main indicator in the decision to perform esophagoscopy for suspected foreign bodies.
对于食管异物疑似嵌顿，在决定是否进行食管镜检查时，有时可能会带来诊断难题。在对嵌顿异物进行诊断性检查后进行硬质食管镜检查却未发现异物的情况并不罕见。本研究旨在明确更有可能出现食管镜检查阴性结果的临床情况。
对本部门98例因疑似异物而进行的硬质食管镜检查进行回顾性分析，试图明确食管镜检查未发现异物的患者与发现异物的患者在临床和放射学表现上的特征。
在22例食管镜检查阴性结果中，20例与疑似骨（主要是鱼刺）嵌顿有关。与阴性结果相关的其他参数包括症状持续时间延长和体格检查阳性发现。在疑似骨嵌顿中，钡餐检查和颈部X线检查对确定异物的存在并无帮助。
临床病史是决定对疑似异物进行食管镜检查的主要指标。
