Application of multi-disciplinary treatment in standardized diagnosis and treatment of esophageal foreign body / 临床外科杂志

Objective To investigate the safety and efficiency of multiple-discipline cooperated diagnosis and treatment on esophageal foreign body and to discover the risk factors of patients who need surgical treatment compared with medical treatment.Methods The information of 108 patients who was diagnosed with esophageal foreign body from January 2014 to June 2021 and accepted multiple-discipline cooperated diagnosis and treatment consisted of cardiothoracic surgery department,digestive system department,emergency department,imaging department and anesthesiology department was collected.Then,we compared the difference of clinic time,foreign body type,endoscopic findings,position of incarnation,complications,postoperative hospital stay between surgical treatment and medical treatment.Results Patients in medical treatment were older than surgical treatment[(59.21±13.12)years VS.(52.65±12.66)years,P＜0.05].Clinic time shew a skewed distribution,clinic time was longer in surgical treatment compared with medical treatment by rank sum test(P＜0.05).There were statistical differences in foreign body type,esophageal injury and complications between the two groups(P＜0.05).The white blood cell count of endoscopic treatment group and surgical treatment group was(7.89±3.08)× 109/L and(11.69±6.98)× 109/L,respectively(P＜0.05),neutrophil counts were(6.16±2.96)× 109/L and(9.97±6.97)× 109/L,respectively(P＜0.05),proportion of neutrophils were(76.11± 8.75)％ and(81.52±12.52)％,respectively(P＜0.05),and C-reactive protein level were(43.26± 56.87)mg/L and(111.37±102.86)mg/L,respectively(P＜0.05).Conclusion Multiple-discipline cooperated diagnosis and treatment is safe,rapid and effective in the diagnosis and treatment of esophageal foreign bodies.Patients with longer clinic time,higher white blood cell counts,higher neutrophil counts,higher proportion of neutrophils,and higher C-reactive protein level were more likely to require surgical treatment.

Diagnosis and treatment of esophageal foreign body: Operation or endoscopy? / 中国胸心血管外科临床杂志

@#Objective    To summarize our experience in the treatment of esophageal foreign bodies. Methods    A retrospective analysis of 149 patients of esophageal foreign bodies in the Second Affiliated Hospital of Air Force Military Medical University from December 2011 to May 2019 was carried out, including 75 (50.3%) females and 74 (49.7%) males with an average age of 57 (2-85) years. Results    There were 146 patients confirmed by endoscopy, and 3 patients were not found foreign body. Among the confirmed patients, 127 patients were removed by gastroscope and 19 patients were treated by operation. Esophageal foreign bodies are mainly related to the types of food. Jujube seed is the most common food foreign body in the northwest China. The injury rate of mucosal was 47.54% within 48 hours. The complication rate of taking out the foreign body after 48 hours was 100.0%. The success rate by endoscopy decreased (P=0.005), if the foreign body combined perforation. There was no statistical difference between the neck and other parts when using ultra-fine gastroscope (P=0.157). Conclusion    The sharper the foreign body is, the easier the perforation is. The earlier the foreign body is removed, the less complications are. The size of the foreign body determines the difficulty of endoscopic removal. Gastroscopy is the first choice for diagnosis and treatment, especially ultra-fine gastroscopy, and the foreign bodies that cannot be removed by endoscopy need surgical treatment.

A rare case of food bolus impaction on top of stricture formation secondary to a 12- year retained foreign body (denture) in the esophagus of a 34-year old male: A case report

OBJECTIVES@#This paper aims to present a rare case of a 34-year old male who had esophageal food bolus impaction on top of stricture formation secondary to a retained 12-year esophageal foreign body (denture). It also aims to state the significance of proper and comprehensive history taking, physical examination and corresponding ancillary procedures to arrive at its diagnosis and to highlight the importance of a multidisciplinary team in the prevention and management of complicated foreign body (FB) impaction.@*DESIGN@#Case Report@*SETTING@#Government Tertiary Hospital@*PATIENT@#One@*RESULTS@#A 34-year old male presented with one day history of dysphagia after ingesting a chunk of pork. He had no other symptoms and was not in any respiratory distress. Physical examination was unremarkable except for missing dentition (teeth #8, #9 by universal notation system). Radiographic imaging, esophagogram and contrast-enhanced chest CT scan revealed partial proximal esophageal obstruction probably secondary to retained foreign body at the level ofT5 vertebra. Rigid esophagoscopy with removal of foreign body (food bolus) was done. However, there was difficulty insinuating the scope beyond this level. Further investigation and the use of multispecialty collaboration eventually led to the retrieval of a 12-year denture covered by a bimucosal flap with surrounding stricture formation.@*CONCLUSION@#Foreign body impaction, while more commonly found in the pediatric population, may also occur in adults especially those with edentulism, psychiatric disorders, alcoholism and preexistent esophageal pathologies. In rare cases, patients may be asymptomatic resulting to a delay in its diagnosis. In addition to a well-taken history and physical examination, direct visualization and computed tomography are vital for evaluation. A multidisciplinary approach is critical in its management especially when anticipating difficult extraction and considering FB impaction complications.

Surgical treatment of latent infection of 2019 novel coronavirus (SARS-CoV-2) with esophageal foreign body perforation: A case report / 中国胸心血管外科临床杂志

@#This study reports the surgical treatment of a female patient at age of 64 years with novel coronavirus (SARS-CoV-2) latent infection complicated with esophageal foreign body perforation with no significant changes in the lung CT. The patient was confirmed as SARS-CoV-2 infection on the 4th day after surgery and then was transferred into the Department of Infectious Disease in our hospital for treatment. This case has guiding value for the operation of thoracic surgery during the outbreak of novel coronavirus pneumonia.

A comparison of clinical effects of removing foreign bodies from esophagus by rigid esophagoscope and flexible esophagoscope / 中国胸心血管外科临床杂志

@#Objective    To collect the data of esophageal foreign body patients, and to evaluate the clinical effects of two different surgical methods in our hospital. Methods    The clinical data of 294 patients who were treated in Gansu Provincal Hospital from January 2012 to June 2018 were analyzed retrospectively. The clinical data were collected and analyzed by SPSS 22.0. In order to to evaluate the efficacy of flexible esophagoscope (FE) and rigid esophagoscope (RE) in the treatment of esophageal foreign bodies.The patients were divided into two groups: a RE group including 118 patients with 62 males and 56 females at age of  6 (3-37) years and a FE group including 176 patients with 84 males and 92 females at age of 6 (3-59) years. Results    There was no significant difference in age, age stratification, gender and foreign body type between the two groups. There was a statistical difference in the initial clinical symptoms (P=0.041) or in esophageal foreign bodies position (P=0.037) between the two groups. The success rate of foreign body removal was similar between the two groups (P=0.632). The success rate was 88.9% (105/118) in the RE group, 87.5% (154/176) in the FE group. The operation time was significantly longer in the RE group than that in the FE group (10.8 ±17.4 min vs. 17.5±21.6 min, P<0.001). The postoperative hospitalization time in the RE groups was longer than that in the FE group (21.5 ±24.2 hours vs. 12.5 ±21.3 hours, P<0.05). There was a statistical difference in the incidence of postoperative complications between the two groups (P=0.034). In the RE group, the main complication was mucosal edema (15.3%). And the rate of bleeding was higher (15.9%) in the FE group. There were 30 patients (25.5%) in the RE group with minor postoperative complications versus the FE group with 40 patients (22.7%); and 1 patient (0.8%) in the RE group with severe complications versus the FE group with 5 paients (2.8%). Conclusion    Based on the analysis of this study, it is found that RE has higher safety. But the indications are strict, the professional requirements of the operator and the selection of patients are stronger. The FE is convenient to use, the operation crowd is wide, and the suitable crowd is wide. Therefore, for specific patients, after improving the relevant examination and preoperative evaluation of patients, clinicians need to choose appropriate surgical methods to ensure the success of the operation, and reduce the postoperative complications as far as possible.

Effect of transparent cap-assisted endoscopic esophageal foreign body removal / 中国内镜杂志

Objective To compare the operation effect of esophageal foreign body removal with transparent cap-assisted endoscopic technique and traditional method. Methods Ninety-six patients with foreign body incarcerated in esophageal were randomly divided into two groups, and they were underwent transparent cap-assisted endoscopic esophageal foreign body removal or traditional endoscopic esophageal foreign body removal respectively. The clinical data of the two groups were collected, and the success rate, the operation time, the endoscopic vision clarity and the complication rate of the two groups were all recorded and analyzed. Results The success rate in transparent cap-assisted endoscopic technique group was 100% compared with 95.83% in traditional method group, and two cases of failure were transferred to transparent cap-assisted endoscopic technique and finally succeed. The mean operation time were (8.58±3.21) min in transparent cap-assisted endoscopic technique group, and (10.64 ± 5.45) min in traditional method group, and there was no significant difference in two groups (P > 0.05). Forty-five cases got A level and three got B in transparent cap-assisted endoscopic technique group in endoscopic vision clarity, in contrast to 35 A, 11 B and two C in traditional method group. The difference between the two groups was statistically significant (P = 0.020). There was no case with serious complications such as bleeding, perforation or death in two groups. Conclusions Transparent cap-assisted endoscopic technique for body removal is safety and efficacy, and this technique can provide better endoscopic operation field of vision and help improve the success rate of esophageal foreign body removal.

Application of the Hopkins Endoscope on Removal of Esophageal Foreign Bodies / 中国医科大学学报

Objective To evaluate the clinical application value of Hopkins endoscope on removal of esophageal foreign bodies. Methods The clinical data of 96 patients with esophageal foreign body were analyzed retrospectively. Then the differences of the operation time between the visual surgery guided by Hopkins endoscope and conventional surgery of removal of esophageal foreign bodies were compared. Results Improved surgical operation time is significantly shorter than the traditional operation group. In addition,the operation time of improved surgery in the denture group,≥50 years old age group,≥24 h course group and the first stenosis of esophagus group is significantly shorter than the traditional ones. Conclusion Compared with the traditional surgery,the visual surgery of removal of esophageal foreign bodies guided by Hopkins endoscope with rigid esophago?scope has more advantages,especially for complex esophageal foreign body,which can significantly short the operation time and improve the opera?tion efficiency.

The use of a soft gel capsule as a medium for modified barium esophagogram in detecting esophageal foreign body

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To  test  a  soft  gel  capsule  with  barium  sulfate  as  a  medium  for  modified  barium esophagogram in detecting esophageal foreign body.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Preliminary Diagnostic Test Assessment; Consecutive Convenience Sample<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> Soft gel capsule with barium sulfate was pilot tested on patients with a history and diagnosis of radiolucent foreign body ingestion between June 1 and November 30, 2014.<br /><strong>RESULTS:</strong> Seven  patients  (6  males,  1  female;  aged  26  -  61  years)  underwent  the  procedure.  In all seven, the enhanced capsule immediately stopped above the level  of  the  esophageal foreign body, easily identifying the exact location of the obstruction. Foreign bodies included 1 embryonated  duck-egg  white "balut",  5  chunks  of  pork  meat  and  1  claspless  denture. All  were successfully  marked  by  the  capsule  on  fluoroscopy  and  documented  on  X-ray.  Esophagoscopy under general anesthesia was successfully performed after fluoroscopy in all patients.<br /><strong>CONCLUSION:</strong> We   were   able   to   improvise   a   new   medium   for   use   in   modified   barium esophagograms  that  was  easy  to  prepare  and  that  rendered  good  radiographic  imaging  and localization of radiolucent foreign bodies. A randomized trial in comparison to the prevailing test  may  confirm  our  findings  further.  Meanwhile,  we  recommend  exploring  the  procedure in  other  hospitals  as  an  alternative  to  barium-soaked  cotton  in  the  diagnosis  of  radiolucent esophageal foreign bodies</p>

Perforación esofágica por cuerpo extraño / Esophageal perforation by foreign body

Presentamos un caso de perforación esofágica por cuerpo extraño. Las causas de perforación esofágica pueden clasificarse en: instrumentales, espontáneas, quirúrgicas, traumáticas y cuerpos extraños. La perforación esofágica es una situación grave con alto índice de morbimortalidad debido a su difícil diagnóstico y falta de consenso pleno en su tratamiento. La clínica es polimorfa e inespecífica y el diagnóstico requiere alto grado de sospecha. La mortalidad oscila entre 10 y 40%.

We report a case of esophageal foreign body perforation. The causes of esophageal perforation can be classified into: instrumental, spontaneous, surgical, trauma and foreign bodies. Esophageal perforation is a serious condition with high morbidity and mortality rates due to its difficult diagnosis and lack of full consensus on treatment. The clinic is polymorphous and unspecific and diagnosis requires a high index of suspicion. Mortality ranges from 10 to 40%.

Application of Three-dimensional Reconstruction in Esophageal Foreign Bodies

This study was conducted to investigate the clinical application of three-dimensional (3D) reconstructed computed tomography (CT) images in detecting and gaining information on esophageal foreign bodies (FBs). Two patients with esophageal FBs were enrolled for analysis. In both cases, 3D reconstructed images were compared with the FB that was removed according to the object shape, size, location, and orientation in the esophagus. The results indicate the usefulness of conversion of CT data to 3D images to help in diagnosis and treatment. Use of 3D images prior to treatment allows for rapid prototyping and surgery simulation.

Endoscopic Removal of an Impacted Fishhook That Was in the Esophagus for Two Months / 대한소화기내시경학회지

An esophageal foreign body has clinical significance because it may cause serious complications such as esophageal perforation, mediastinitis and/or aorto-esophageal fistula. A prompt attempt to remove an esophageal foreign body via flexible endoscopy should be made when the shape of the foreign body is especially sharp and long as it can easily lead to esophageal perforation. We report here on a case of endoscopic removal of an impacted esophageal foreign body, a fishhook, that hade been present in the esophagus for two months, and there were no serious complications from the procedure.

A Case of Esophageal Foreign Body Induced by Glue Ingestion / 대한소화기내시경학회지

Foreign bodies of the upper gastrointestinal tract are usually discovered in children, persons with esophageal disease, prisoners with a purpose of secondary gain, and mentally disturbed or disabled individuals. In adults, accidentally or intentionally ingested foreign bodies such as dentures, coins, corks, toothbrush, needles, and nails are reported. To our knowledge, there has been one case of gastric bezoar caused by glue ingestion that was removed by surgical operation in Korea. However, there has been no case report of esophageal foreign body caused by glue ingestion neither in Korea nor elsewhere. We report a case of a man with a history of chronic glue inhalation, who ingested glue with suicidal intent, that was solidified from the upper esophagus to the stomach. It was successfully removed by therapeutic endoscopy.

Removal of Esophageal Blunt Foreign Bodies by Using a Foley Balloon Catheter in the Emergency Department

BACKGROUND: In most cases of a foreign body in the esophagus, an ENT specialist is consulted, which may be time consuming if not evaluated in a timely fashion. The patients are admitted to the hospital and sent to the operating room, where they are placed under anesthesia and the object is removed by using an esophagoscope. METHODS: A prospective randomized trial was conducted during the period from January 1998 to June 2000. All patients presenting to emergency department with blunt objects in the esophagus were included. In one group, with fluoroscopic guidance, a Foley catheter was placed to remove the blunt foreign bodies. And in the other group, we removed them by using the esophagoscpe. We used the t-test for statistical analysis in this study. RESULTS: Total number of patients enrolled in this study was 38. 22 patients were enrolled in the Foley Catheter removal group, and the remaining 16 were enrolled in the esophagoscope removal group. The success rate for the Foley catheter was 21/22(95.5%), and that for the esophagoscope was 15/16(93.8%). The average time of removal for the Foley catheter group was 0.70+/-0.28 hours while that for the esophagoscope group was 5.96+/-2.22 hours. One side effect, nonfatal hypoxia, was noted in the Foley catheter removal group. The average cost for the Foley catheter group were 78,800 won(approximately 60 US dollars) while that for the esophagoscope group took 722,800 won(approximately 600 US dollars). CONCLUSION: In our study, we found that the success rate for removing blunt foreign bodies from the esophagus by using a simple Foley catheter was high, also the Foley catheter was a time saving and cost effective procedure with an excellent safety profile.

Complicated esophageal foreign bodies: Diagnosis and treatment in 64 cases / 中国微创外科杂志

Objective To summarize the experience in the diagnosis and management of complicated esophageal foreign bodies. Methods A retrospective study was conducted in 64 patients with complicated esophageal foreign bodies from January 1994 to July 2004 in this hospital. Types and location of foreign bodies ingested were analyzed. Results Animal bones accounted for 50% of foreign bodies ingested (32/64) and foreign bodies located at the esophageal inlet in 68.75% of the patients (44/64). Dental prostheses ingestion (30 0%) and the impaction at the level of the second esophageal constriction (43 3%) were more encountered in the middle-to-old aged patients than in patients under the age of 50 ( P

Esophageal Foreign Body(Coin) Removal Using Foley's Catheter / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Esophageal foreign bodies are very common problems in the field of pediatric otolaryngology department. Of all, coins are the most common esophageal foreign bodies encoutnered. Management of the child with an esophageal coin is as follows: rigid esophagoscopic removal under general anesthesia, flexible endoscopic removal, Foley's catheter technique with or without fluoroscopy control, and advancement using bougination. This study is to evaluate the safety and efficiency of the procedure of removing coins from the esophagus in children using Foley's catheter without fluoroscopic control. MATERIALS AND METHODS: The subjects consisted of 101 children with coin lodgement in the first esophageal constrictor area who had been managed with Foley's catheter extraction method from April 1993 through February 1999 at Masan samsung hospital, Masan, Korea. A retrospective review of charts and radiological findings was performed. RESULTS: Of the 101 children who underwent Foley's catheter extraction method, 93 cases (92.1%) were successful without serious complications; but three attempts were unsuccessful and were subsequently removed by rigid esophagoscopy under general anesthesia. CONCLUSIONS: Foley's catheter extraction method may be used for removal of esophageal coins in selected cases, even without fluoroscopic control. The technique is effective, safe and avoids the risk of general anesthesia or radiation exposure.

A Case of Esophageal Foreign Body Causing Unilateral Vocal Cord Paralysis / 대한이비인후과학회지

Foreign bodies in the upper aerodigestive tract are one of the most frequently encountered accidental cases in the otolaryngological fields, and may cause severe complications such as esophageal ulceration, esophageal perforation, periesophagitis, tracheoesophageal fistula, mediastinitis, pneumothorax and pyothorax. Therefore, speedy diagnosis and early intervention is needed to reduce morbidity and mortality. Recently, we experienced a rare case of esophageal foreign body which caused unilateral vocal cord paralysis. We report this case with a review of literature.

A Case of Hypernatremia due to Esophageal Foreign Body

Hypertonic or hypernatremic dehydration, which is uncommon in pediatric patients beyond infancy, has a distinct pathophysiology that differentiates the clinical presentation and management from other forms of dehydration. Severe hypernatremia may precipitate central nervous system injury, seizures, intracerebral bleeding, retardation, and even death. Causes of hypernatremia include inadequate water intake, salt overload, extrarenal water loss, defective osmoregulation, and water loss with simultaneous gain of solute. We experienced a case of hypernatremia due to esophageal foreign body. These authors reported a case with review of literatures.

A Case of Congenital Esophageal Stenosis Presented with Esophageal Foreign Body / 대한이비인후과학회지

Congenital esophageal stenosis is a extremely rare disease in childhood. We experienced one patient with a case of esophageal stenosis with esophageal solid food impaction. According to her history of dysphagia, cine esophagogram, pH-monitoring, and esophagoscopic findings, this esophageal stenosis was confirmed as congenital stenosis. We thus reported this case along with a relevant literature review.