Kürkciyan I, Frossard M, Kettenbach J, Meron G, Sterz F, Röggla M, Laggner A N
Department of Emergency Medicine, General Hospital of Vienna, University of Vienna, Austria.
Z Gastroenterol. 1996 Mar;34(3):173-7.
There are at present no clear guidelines whether foreign body ingestion in the gastrointestinal tract should be managed conservatively, endoscopically or surgically. Retrospectively we have, therefore, analyzed 78 foreign body ingestion's in 42 patients (age 15-72 years) admitted to the Emergency Department of the University Hospital in Vienna. Our intention was to assess the value of a conservative management, defined as daily follow-up visits until the foreign body spontaneously appeared in the feces and to find criteria when endoscopic or surgical management is required. Of 78 foreign bodies, 67 (86%) passed the gastrointestinal tract spontaneously without complications, 9 (11%) were removed endoscopically, and only 2 (3%) required surgery. There were no gastrointestinal perforations. Even foreign bodies with a maximal length of 13.5 cm appeared in the feces spontaneously within a few days. Our data suggests that more than 80% of adults with foreign body ingestion can be managed safely as outpatients by means of conservative treatment. Endoscopic or surgical removal is only indicated in very rare circumstances.
目前，对于胃肠道内异物的处理是应采取保守治疗、内镜治疗还是手术治疗，尚无明确的指导方针。因此，我们回顾性分析了维也纳大学医院急诊科收治的42例（年龄15 - 72岁）有异物吞食史的患者，共78例异物吞食情况。我们的目的是评估保守治疗的价值，保守治疗定义为每日随访直至异物自行随粪便排出，并找出需要进行内镜治疗或手术治疗的标准。在78例异物中，67例（86%）自行通过胃肠道且无并发症，9例（11%）通过内镜取出，仅2例（3%）需要手术治疗。未发生胃肠道穿孔。即使是最长达13.5厘米的异物也在几天内自行随粪便排出。我们的数据表明，超过80%的吞食异物的成年人可以通过保守治疗安全地作为门诊患者进行处理。内镜或手术取出仅在极少数情况下才需要。
