Esophageal foreign bodies: a retrospective analysis of 275 cases

食管异物:275例回顾性分析

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Abstract

BACKGROUND: Esophageal foreign bodies, especially complex foreign bodies, are a clinical emergency that require a specific management strategy. The aim of this study was to analyze the clinical features of adult patients with esophageal foreign bodies, examine different endoscopic management strategies for esophageal foreign bodies, summarize the experience of Department of Gastroenterology of Henan Provincial People's Hospital in the treatment of esophageal foreign bodies, and ultimately improve the success rate of foreign body removal. METHODS: The medical records of 275 adult patients with esophageal foreign bodies successfully treated under endoscopy at the Department of Gastroenterology of Henan Provincial People's Hospital from January 2017 to August 2023 were retrospectively reviewed. RESULTS: Among the 275 patients, 210 patients had no underlying esophageal diseases, while 65 experienced esophageal stricture due to variety of reasons. In the 210 patients, sharp objects were the predominant foreign bodies in the esophagus. The most common location of esophageal foreign bodies was the upper segment, followed by the middle and lower segments. Among the 65 patients with esophageal strictures, the types of esophageal foreign bodies included large food bolus, vegetable pieces, meat chunks, and tablets. Foreign body forceps, snares, and biopsy forceps were the instruments most frequently used to manage these bodies. There were statistically significant differences in the impaction time between different age groups (P<0.05). Of the 275 patients, 20 had esophageal perforation, while the remaining patients showed various degrees of congestion, erosion, or ulceration during endoscopy. CONCLUSIONS: Older adult patients were more likely to experience prolonged impaction. Endoscopic removal of esophageal foreign bodies is safe and effective. An appropriate strategy based on the size, type, and location is needed in order to remove foreign bodies and ensure successful removal, reduce risk, and avoid surgical interventions, especially in cases of complex foreign bodies.

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