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Background: Foreign body(FB) impaction accounts for 4% of emergency endoscopies in clinical practice. Flexible endoscopy(FE) is a recommended therapeutic option because it can be performed under local anesthesia, it is cost effective and is well tolerated. Rigid endoscopy (RG) under general anesthesia is another option and is advantageous in some circumstances. The aim of the study is to compare ef?cacy and safety of ?exible and rigid esophagoscopy in esophageal foreign body removal. It is a prospective study done in E.N.T department in KIMS Methods: MEDICAL COLLEGE, Amalapuram, which includes 50 patients with impacted foreign body esophagus. Parameters like type of foreign body, location of impacted foreign body are included. The study analyzies the type of procedure the patient have undergone, the intra operative and post operative complications. This prospective cohort study includes 50 patients Results: who have undergone surgical procedure for removal of impacted foreign body. Flexible esophagoscopy is performed in 30 patients and rigid esophagoscopy is performed in 20 patients . The most frequent complications are mucosal erosion, mucosal edema, and ulceration. Flexible esophagoscopy and rigid esophagoscopy are equally safe and effective for Conclusion: removal of impacted esophageal foreign body
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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.
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@#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.
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We report a rare case of accidental toothbrush swallowing by a normal adult which was successfully removed by rigid esophagoscope. A 25 year young man presented to casualty of KIMS, Hubli, with ingestion of toothbrush accidentally half an hour before. Patient’s general physical examination and systemic examination was normal. Oral cavity, oropharynx and indirect laryngoscopic findings were normal. An emergency upper GI Endoscopy was done and foreign body was confirmed to be present at 35 cm from upper incisor teeth. Foreign body was removed by rigid esophagoscope under GA. Otolaryngologist is the most common medical faculty consulted for management of aero digestive foreign bodies. Toothbrush swallowing in normal adults is a rare accident. Most of them are found in esophagus and spontaneous passage is unknown and hence the need for early removal.