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Background: Foreign body ingestion and food bolus impaction is a common clinical scenario and can present as an endoscopic emergency. Though majority of them pass spontaneously 10-20% require endoscopic intervention. Flexible endoscopy is recommended as therapeutic measure with minimal complications. The aim of our study is to present 5 years’ experience in dealing with foreign bodies in the upper gastrointestinal tract.Methods: Cases of foreign body ingestion admitted to department of general surgery from March 2015 to March 2020 were evaluated. The patients were reviewed with details on age, sex, type of FB, its location in gastrointestinal tract, treatment and outcome.Results: A total of 55 cases were studied. Age range was 1-85 years. Males were predominant 61.81%. Coins were found most commonly 63.6%. Esophagus was the commonest site of FB lodgement 70.9%. Upper esophagus being the most common 36.36%. Upper gastrointestinal flexible endoscopy was useful in retrieving FB in all the 55 cases. There were no complications throughout the study period.Conclusions: Flexible endoscopy should be used as definitive treatment and endoscopic treatment is safe and effective.
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BACKGROUND/AIMS: Food bolus impaction is the most common form of esophageal foreign body impaction observed in adults. Clinical guidelines recommend using the push technique or retrieval methods in such cases. The push technique can cause injuries in certain clinical situations. Notably, conventional retrieval methods are time and effort consuming. Cap-assisted endoscopic extraction of an impacted food bolus is an easy and effective technique; however, more data are needed for its validation. This study compared the capassisted extraction technique with conventional methods. METHODS: This prospective observational multicenter study compared the success and en bloc removal rates, total procedure time, and adverse events in both techniques.. RESULTS: The study included 303 patients who underwent food bolus extraction. The push technique was used in 87 patients (28.7%) and a retrieval procedure in 216 patients (71.3%). Cap-assisted extraction was performed in 106 patients and retrieval using conventional methods in 110 patients. The cap-assisted technique was associated with a higher rate of en bloc removal (80.2% vs. 15%, p<0.01), shorter procedure time (6.9±3.5 min vs. 15.7±4.1 min, p<0.001), and fewer adverse events (0/106 vs. 9/110, p<0.001). CONCLUSIONS: Cap-assisted extraction showed no adverse events, higher efficacy, and a shorter procedure time compared with conventional retrieval procedures.
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Adult , Humans , Foreign Bodies , Methods , Prospective StudiesABSTRACT
Objective To analyze the effects of different food bolus on esophageal motility in patients with non-obstructive esophageal dyshagia by high-resolution esophageal manometry.Methods From March 2014 to June 2015,48 patients with non-obstructive esophageal dysphagia and 12 healthy volunteers (healthy control group) were enrolled.High-resolution manometry was tested when swallowing liquid food,semisolid food and solid food.The lower esophageal sphincter pressure (LESP),4 second integrated relaxation pressure (4 s IRP),distal contractile integral (DCI),distal latency (DL),and breaks were analyzed.T test was performed for statistical analysis.Results According to the 2014 Chicago classification standard,among 48 patients with dysphagia,esophageal dysmotility was diagnosed in 35 patients (72.9％),while 13 patients (27.1％) had normal esophageal motility,and the most common type of esophageal motility disorder was ineffective esophageal motility (31.2％,15/48).The LESP of the healthy control group was (10.85±3.75) mmHg (1 mmHg=0.133 kPa) and 4 s IRP was (1.90±0.84) mmHg.The LESP of dysphagia group was (12.20 ±8.93) mmHg and 4 s IRP was (3.25± 1.02) mmHg.There was no significant difference in LESP and 4 s IRP between two groups (both P＞0.05).The DCIs of liq(u)id swallows,semisolid swallows and solid swallows of healthy control group were (589.00±292.90),(690.17±52.41) and (808.00±448.53) mmHg · s · cm,respectively,which were significantly lower than those of complete normal group in Chicago classification ((1 346.62 ± 244.83),(1 542.46±231.19) and (1 890.31±363.26) mmHg · s · cm;t=4.76,4.68 and 3.79;all P=0.001).The DL of solid swallows of healthy control group was (7.72± 1.15) s,which was significantly lower than that of complete normal group in Chicago classification ((9.00±1.23) s;t=2.61,P=0.021).The breaks of liquid swallows,semisolid swallows and solid swallows of healthy control group were (2.33 ±1.74),(2.37±1.72) and (1.53± 1.22) cm,respectively,which were higher than those of complete normal group in Chicago classification ((0.58±0.48),(0.52±0.47) and (0.85±0.53) cm),and the differences were statistically significant (t =3.02,3.68 and 2.54,all P ＜ 0.05).Conclusions The most common type of esophageal motility disorder in patients with non-obstructive esophageal dysphagia is ineffective esophageal molitity.When swallowing food,the patients with dysphagia but normal results of esophageal manometry according to Chicago classification require more strength of the esophagus,more complete contraction and longer peristaltic time to swallow food bolus.
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Choking is one of the important types of asphyxia deaths. The incidences of which are not uncommon. The choking in children could be due toys, coins, marbles, nuts and any other small hard object or even sometimes due to stuffed in plastic bags whereas in adults most of the times food bolus or hard parts of food like bone pieces are responsible. It is mostly accidental in nature. It can cause coughing or sometimes airway obstruction leading to death. We present a case wherein a mentally ill person accidentally choked to death after consumption of food.