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Endoscopic Management of Adult Foreign Bodies in the Upper-Gi Tract: Clinical Experiences at a Tertiary Hospital in Southern Taiwan

成人上消化道異物的內視鏡處理:南台灣醫學中心之臨床經驗

摘要


Background and Aims: Foreign object ingestion and food bolus impaction are common clinical problems even among adults. However, local literature is scarce. We report our real world clinical experience using endoscopic management to treat adult foreign body ingestion and food bolus impaction.Methods: A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction who presented at Kaohsiung Chang Gung Memorial Hospital between November 2010 and October 2011. The clinical variables analyzed were age, gender, the type, number and location of the foreign bodies, associated upper gastrointestinal diseases, the endoscopic method used, the accessory device used and any symptoms and complications during the removal procedure.Results: A total of 50 patients (53 incidents) met the inclusion/exclusion criteria and were included in the study (male/female: 1/1.08; age 53 ± 18 years). Among them, 36 foreign bodies were found successfully (67.9%). Most of the foreign bodies were located in the esophagus (66.7%). Food bolus impaction was the most common finding (38.9%). The majority of foreign bodies in current study were successfully extracted (94.4%) and only one case required surgical intervention. A comparison between the symptomatic and asymptomatic patients revealed that a male gender, a sharp foreign body and the location of foreign body in the pharynx/esophagus were the significant relevant factors. Early endoscopic intervention seems to increase the detection rate.Conclusions: Endoscopic management is a safe and highly effective procedure when treating foreign body ingestion and food bolus impaction.

並列摘要


Background and Aims: Foreign object ingestion and food bolus impaction are common clinical problems even among adults. However, local literature is scarce. We report our real world clinical experience using endoscopic management to treat adult foreign body ingestion and food bolus impaction.Methods: A retrospective chart review study was conducted on adult patients with foreign body ingestion and food bolus impaction who presented at Kaohsiung Chang Gung Memorial Hospital between November 2010 and October 2011. The clinical variables analyzed were age, gender, the type, number and location of the foreign bodies, associated upper gastrointestinal diseases, the endoscopic method used, the accessory device used and any symptoms and complications during the removal procedure.Results: A total of 50 patients (53 incidents) met the inclusion/exclusion criteria and were included in the study (male/female: 1/1.08; age 53 ± 18 years). Among them, 36 foreign bodies were found successfully (67.9%). Most of the foreign bodies were located in the esophagus (66.7%). Food bolus impaction was the most common finding (38.9%). The majority of foreign bodies in current study were successfully extracted (94.4%) and only one case required surgical intervention. A comparison between the symptomatic and asymptomatic patients revealed that a male gender, a sharp foreign body and the location of foreign body in the pharynx/esophagus were the significant relevant factors. Early endoscopic intervention seems to increase the detection rate.Conclusions: Endoscopic management is a safe and highly effective procedure when treating foreign body ingestion and food bolus impaction.

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