Shi WS, Su ZY, Wei CY, Chen XF, Liu SS, Fu X, Liu DL, Cui GH. Clinical features and standardized diagnosis and treatment of esophageal foreign bodies.
Shijie Huaren Xiaohua Zazhi 2017;
25:2721-2730. [DOI:
10.11569/wcjd.v25.i30.2721]
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Abstract
AIM
To summarize the clinical characteristics of esophageal foreign bodies and to explore their standardized diagnosis and treatment.
METHODS
This retrospective study was conducted at our hospital from July 2011 to July 2017, and we reviewed the clinical data for 1190 patients with esophageal foreign bodies with regard to their sex, age, department patients first visited, treatment time, type, incarcerated site, treatment plan, and length of hospital stay.
RESULTS
Of 1190 patients included, 568 were male and 622 were female, with a male-to-female ratio of 1.0:1.1. They aged from 2 mo to 99 years (mean, 45 years ± 28.44 years), with a median age of 54 years; 293 (24.6%) patients were under 15 years, 293 (24.6%) were between 15 and 55 years, and 604 (50.8%) over 55 years. Otolaryngology and head surgery department was the most first-visited department (966, 81.2%), followed by gastroenterology department (138, 11.6%), thoracic surgery department (46, 3.4%), and others (40, 3.4%). There were 716 (60.2%) patients who visited hospital within 24 h, 126 (10.6%) in 24 to 72 h, and 348 (29.2%) over 72 h. The foreign bodies were plant-based in 448 (37.6%) patients, animal-based in 403 (33.9%), metallic in 200 (16.8%), and composite material-based in 139 (11.7%), with jujube pits, chicken bones, and coins accounting for 62.9% (750 patients) of all cases. The foreign bodies were most commonly located in the upper orifice of the esophagus (827, 69.5%), followed by the upper part (245, 20.6%), the middle and lower parts (94, 7.8%), and others (25, 2.1%). We treated 1088 (91.4%) patients by endoscopy and 41 (3.4%) by surgery. The duration of hospitalization ranged from 1 to 71 d (median, 5 d; mean, 5.9 d ± 4.9 d).
CONCLUSION
Esophageal foreign bodies most commonly occur in the upper orifice of the esophagus. Standardized diagnosis and treatment are important. Esophageal foreign bodies should be taken out within 24 h. Timely correction of water and electrolyte disturbance, effective antibiotic therapy, high nutrition support, and temporary esophageal, if necessary, are beneficial to the patient's recovery.
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