内镜下清除上消化道异物:一项回顾性队列研究

Alpaslan Fedayi Çalta
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引用次数: 0

摘要

背景/目的:胃肠道异物诊断和治疗的延误可能导致严重的并发症。在这项研究中,我们旨在回顾性评估在我们诊所接受急诊上消化道内窥镜检查异物摄入的患者。方法:2015年至2022年间,我们评估了68例预先诊断为异物摄入的急诊上消化道内窥镜检查患者。评估包括年龄、性别、主诉、异物类型、定位和治疗参数等因素。结果:纳入研究的68例患者中,女性21例(30.89%),平均年龄54.00岁。其中43例(63.23%)无主诉,23例(33.82%)有吞咽困难和吞咽困难,2例(2.94%)有呕吐。吞咽物品分类:硬币(n=2)、大头针(n=5)、电池(n=11)、药物斑块(n=6)、食道异物(n=7)、肉块(n=5)、鸡骨(n=4)、鱼骨(n=5)、剃刀(n=7)、打火机(n=3)、牙签(n=1)。异物位于食道23例(33.82%),胃32例(47.05%),十二指肠1例(1.47%)。12例(17.64%)患者在内镜下未检出异物,但通过放射学方法检出。成功取出异物54例(79.41%)。1例(1.47%)患者无法通过内窥镜切除,另1例(1.47%)患者因异物(牙签)导致胃肠道穿孔,均行手术治疗。结论:早期诊断和治疗异物误食是预防严重并发症的关键。内窥镜检查是一种微创手术,是外科手术的一种安全选择,外科手术可能有更高的发病率和死亡率风险。
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Removal of foreign objects seen in the upper gastrointestinal tract with the help of endoscopy: A retrospective cohort study
Background/Aim: Delay in diagnosing and treating gastrointestinal (GI) tract foreign bodies may lead to serious complications. In this study, we aimed to retrospectively evaluate the patients who underwent emergency upper GI endoscopy for foreign body ingestion in our clinic. Methods: Between 2015 and 2022, we evaluated 68 patients who underwent emergency upper GI endoscopy with a prediagnosis of foreign body ingestion. The evaluation included factors such as age, gender, presenting complaints, foreign body type, localization, and treatment parameters. Results: Out of the 68 patients included in the study, 21 (30.89%) were female, and the mean age was 54.00 years. Among them, 43 (63.23%) presented with no active complaints, 23 (33.82%) with dysphagia and odynophagia, and two (2.94%) with vomiting. The swallowed objects were classified as follows: coin (n=2), pin (n=5), battery (n=11), drug plaque (n=6), esophageal foreign body (n=7), piece of meat (n=5), chicken bone (n=4), fish bone (n=5), razor (n=7), lighter (n=3), and toothpick (n=1). The foreign bodies were located in the esophagus in 23 cases (33.82%), in the stomach in 32 cases (47.05%), and in the duodenum in one case (1.47%). For 12 patients (17.64%), the foreign body could not be detected endoscopically but was detected using radiologic methods. Among the foreign bodies, 54 (79.41%) were successfully removed. In one patient (1.47%) who could not be removed endoscopically and another patient (1.47%) who developed gastrointestinal perforation due to a foreign body (toothpick), a surgical procedure was performed. Conclusion: Early diagnosis and treatment of foreign body ingestion are crucial in preventing serious complications. Endoscopy, a minimally invasive procedure, can be a safe alternative to surgical procedures, which may carry higher morbidity and mortality risks.
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