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Endoscopic management of impacted esophageal foreign bodies

Authors


  • Authors’ contributions:
  • Conception and design: Li-Qing Yao, Yun-Shi Zhong, and Tao Chen;
  • Analysis and interpretation of the data: Tao Chen, Hai-Fu Wu, and Qiang Shi;
  • Drafting of the article: Tao Chen, Hai-Fu Wu, and Yun-Shi Zhong;
  • Critical revision of the article for important intellectual content: Hai-Fu Wu, Ping-Hong Zhou, Shi-Yao Chen, and Mei-Dong Xu;
  • Final approval of the article: Yun-Shi Zhong and Li-Qing Yao.
  • Disclosure: The authors report that there are no disclosures relevant to this publication.
  • Open access: This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Summary

There are many reports on the endoscopic management of ingested foreign bodies in the upper gastrointestinal tract, however, little is known about the management of a specific subset of esophageal foreign bodies – impacted esophageal foreign bodies (IEFBs), especially perforating esophageal foreign bodies (PEFBs). The aim of this retrospective study on 78 cases was to report experience and outcome in the endoscopic management of the IEFBs in Chinese patients. From January 2006 to July 2011, a total of 750 patients with suspected upper gastrointestinal foreign bodies were admitted to the endoscopy center. Among these 750 patients, 78 cases that met the defined criteria of IEFBs were retrospectively enrolled in the present study, including 12 cases (12/78, 15.4%) with PEFBs. The major types of IEFBs were poultry bones (35.9%) and fish bones (17.9%). Most of the IEFBs (80.8%) were located in the upper esophagus, as were two thirds (66.7%) of the PEFBs. Foreign-body retrieval forceps were the most frequently used accessory devices. Extraction of IEFBs failed in eight patients (10.3%) during the endoscopic procedure. The difficult points in endoscopic management were PEFBs, IEFBs with sharp points, and those with impaction for more than 24 hours. IEFBs should be treated as early as possible, and their endoscopic management is safe and effective. Endoscopic management is the first choice for PEFBs when the duration of impaction is less than 24 hours and there are no abscesses outside of the esophageal tract as determined by a computed tomography scan.

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