1. The analysis of 232 patients with esophageal foreign bodies

Year 2023, Volume: 2 Issue: 3, 52 - 57, 30.12.2023

Özgür Katrancıoğlu , Şule Karadayı , Eftal Sert

https://doi.org/10.58651/jomtu.1362789

Abstract

Background: Esophageal foreign bodies (EFB), which can be seen in adults as well as being more common in the pediatric population, are important because of their serious and life-threatening complications when diagnosed late. For this reason, we aimed to review EFBs.
Materials and Methods: Hospital records of 232 patients who underwent emergency rigid esophagoscopy with the prediagnosis of EFB in our clinic between January 2007 and April 2023 were reviewed retrospectively. Esophagoscopy was performed with rigid esophagoscopy under general anesthesia.
Results: Of these patients, 134 (57.8%) were male. The median age was 5.50 years ± 2.12 years in the pediatric population and 50.26 years ± 16.33 years in the adult population. The mean time from insertion of the foreign body into the esophagus to removal with a rigid esophagoscope was 13.1 hours. The foreign body was localized in the cervical esophagus at a rate of 67.5%. In the pediatric group, the most encountered foreign body was a metal coin, while in the adult group, it was a bone fragment. Rigid esophagoscopy (n = 160) or direct laryngoscopy (n =72) was used for the removal of the EFB. Esophageal perforation was seen in a total of 7 (3.0%) patients. Mortality was observed in 3 (1.3%) of our patients. Mortality was observed in 3 (1.3%) of our patients. Two of these were due to mediastinitis, and one was due to additional diseases.
Conclusions: Early diagnosis and treatment of EFBs is important because of the seriousness of their complications. Foreign body removal by rigid esophagoscopy is a reliable treatment method that should be performed as soon as possible. If the foreign body is sharp-edged and has penetrated the esophageal wall, it cannot be removed without complication; it should be removed by surgical operation.

Keywords

Esophagus, foreign body, rigid esophagoscopy.

Özofagusta yabancı cisim bulunan 232 hastanın analizi

Abstract

Amaç: Pediatrik popülasyonda daha sık görülmesinin yanı sıra erişkinlerde de görülebilen özofagus yabancı cisimleri (ÖYC), geç tanı konduğunda komplikasyonlarının ciddi ve hayatı tehdit edebilecek özellikte olması nedeniyle önemlidir. Bu nedenle ÖYC’lerini gözden geçirmeyi amaçladık.
Materyal ve Metot: Ocak 2007- Nisan 2023 yılları arasında kliniğimizde ÖYC ön tanısıyla acil rijit özofagoskopi yaptığımız 232 olgunun hastane kayıtları retrospektif olarak incelendi. Özofagoskopi genel anestezi altında rijit özofagoskopi ile yapıldı.
Bulgular: Bu hastaların 134'i (%57,8) erkek idi. Medyan yaş pediatrik ve yetişkin popülasyonda sırasıyla 5,50 ±2,12 ve 50,26±16,33 idi. Yabancı cisimin özofagusa takılmasından rijit özofagoskopla çıkarılmasına kadar geçen süre ortalama 13,1 saat idi. Yabancı cisim %67,5 oranında servikal özofagusta lokalize idi. Pediatrik grupta en sık rastlanan yabancı cisim madeni para iken erişkin grupta kemik parçası idi. ÖYC'nin çıkarılması için rijit özofagoskopi (n = 160) veya direkt laringoskopi (n =72) kullanıldı. Toplam 7 (%3,0) hastada özofagus perforasyonu görüldü. Hastalarımızdan 3 (%1,3)’ünde mortalite görüldü. Bunlardan ikisi mediastinite bağlı, biri ise ek hastalıklar nedeniyle idi.
Sonuç: ÖYC’lerinin erken tanı ve tedavisi, komplikasyonlarının ciddi olması nedeniyle önemlidir. Rijit özofagoskopi ile yabancı cisim çıkarılması, en kısa zamanda yapılması gereken güvenilir bir tedavi yöntemidir. Yabancı cisim keskin uçlu, özofagus duvarına penetre olduysa ve komplikasyonsuz çıkarılamayacağı düşünülüyorsa cerrahi operasyon ile çıkarılmalıdır.

Keywords

Özofagus, yabancı cisim, rijit özofagoskopi.

References

• Aiolfi, A., Ferrari, D., Riva, C.G., Toti, F., Bonavina, L, & Bonitta, G. (2018). Esophageal foreign bodies in adults: systematic review of the literature. Scandinavian Journal of Gastroenterology, 53(10-11), 1171-1178.
• Akkuzu, M.Z., Altıntaş, E., Ateş, F., Özdoğan, O., Sezgin, O., Üçbilek, E. & Yaraş, S. (2020). Foreign bodies on the path of nutrition: retrospective evaluation of our clinical experience. Med Bull Haseki, 58, 15-20.
• Binicier, H. C. & Binicier, Ö.B. (2022). Approach to foreign body in esophagus: traditional review. Turkiye Klinikleri Journal of Internal Medicine, 7(1), 7-19.
• Boo, S.J. & Kim, H.u. (2018). Esophageal foreign body: treatment and complications. Korean Journal of Gastroenterology, 72(1), 1-5.
• Hunter, T.B. & Taljanovic, M.S. (2003). Foreign bodies. Radiographics, 23, 731-757.
• Kim, H.u. (2016). Oroesophageal fish bone foreign body. Clinical Endoscopy, 49(4), 318–326.
• Klein, A., Gluck, O., Marom, T., Ovnat-Tamir, S., Rabinovics, N. & Shemesh, S. (2019). Fish bone foreign body: the role of imaging. International Archives of Otorhinolaryngology, 23, 110–115.
• Lin, H.H., Chao, Y.C., Chu, H.C., Hsieh, T.Y., Lee, S.C. & Chang, W.K. (2007). Emergency endoscopic management of dietary foreign bodies in the esophagus. American Journal of Emergency Medicine, 25, 662-665.
• Ma, J., Bae, J.I., Kang, D.K., Park, K.J. & Sun, J.S. (2013). Value of MDCT in diagnosis and management of esophageal sharp or pointed foreign bodies according to level of esophagus. AJR Am J Roentgenol, 201, W707-W711.
• Macpherson, R.I., Hill, J.G., Smith, C.D., Tagge, E. P. & Othersen, H.B. (1996). Esophageal foreign bodies in children: Diagnosis, treatment and complications. AJR Am J Roentgenol, 166, 919-924.
• Nadir, A., Kaptanoglu, M., Nadir, I., Sahin, E. & Karadayi, S. (2011). Esophageal foreign bodies: 177 cases. Diseases of the Esophagus, 24(1), 6–9.
• Pinto, A., Gagliardi, N., Muzj, C., et al. (2012). Role of imaging in the assessment of impacted foreign bodies in the hypopharynx and cervical esophagus. Seminars in Ultrasound, CT, and MRI, 33, 463-470.
• Tumay, V., Zorluoglu, A., Meric, M., Guner, O.S. & Isik, O. (2015). Endoscopic removal of duodenal perforating fishbone—a case report. Chirurgia, 110, 471-473.
• Yavuzer, Ş., Akay, H., Aslan, R., et al. (1977). Özofagus yabancı cisimleri (52 vakanın incelenmesi). AÜTF Mec, 30, 77-106.
• Yao, C.C., Lu, L.S., Wu, I.T., et al. (2015). Endoscopic management of foreign bodies in the upper gastrointestinal tract of adults. BioMed Research International, Volume 2015, Article ID 658602, 6 pages. doi:10.1155/2015/658602.
• Yozgat, A., Cetin, F., Akkas, Y., Avci, E. & Ozaslan, E. (2016). A large delayed esophageal perforation due to chicken bone impaction treated by over-the-scope clipping. Endoscopy, 48(Suppl 1), E253.