Clinical Features And Standardized Diagnosis And Treatment Of Esophageal Foreign Body Of Central China

BACKGROUNDEsophageal foreign body is a common and critical illness in the clinical work of related departments as well as daily life.It happens among all ages periods,and incarcerated closely to its physiological or pathological narrow place because of partial and entire esophageal narrow both congenital or acquired,swallow accidentally of various types of foreign body,neurologic sequela and mental factors.If diagnosis and treatment is inappropriate or delayed,There may be a variety of serious complications like perforation 、 infection 、 bleeding,and even become life-threatening.There is no guidelines for the diagnosis and treatment of esophageal foreign bodies in our country.The collected and analyzed of clinical features of confirmed patients of esophageal foreign body in our hospital recent 7 years,to summarize and discuss the clinical standardized procedures,to provide help for the diagnosis and treatment of esophageal foreign bodies.OBJECTIVETo summarize the clinical features of patients of esophageal foreign bodies in the First Affiliated Hospital of Zhengzhou University recent 7 years,and provide a reference for its diagnosis and treatment as well as investigate standardized procedures.METHODSThe clinical records of 1190 confirmed patients with esophageal foreign bodies ingestion treated in the First Hospital of Zhengzhou University between July 2011 and July 2017 were collected.And the group of gender,age,first-visited department,treatment time,type of the body,incarcerated place,treatment plan,length of hospital stay,incision and prognosis were analyzed.RESULTSEsophageal foreign bodies were confirmed in 1190 patients(568 males and 622 females),with 10 males for every 11 females;They aged ranged from 2 months to 99 years(mean: 45 ± 28.44 years,median: 54 years),and 293(24.6%)patients were <15 years,293(24.6%)patients were between 15 and 55 years,and 604(50.8%)patients >55 years;The most common first-visited department were otorhinolaryngology head and neck surgery with 966(81.2%)patients,followed by gastroenterology department 138 cases(11.6%),thoracic surgery department 46 cases(3.8%),and others 40(3.4%)cases;There were 716(60.2%)patients who came to hospital within 24 hours after impaction,126(10.6%)patients did between 24 and 72 hours,and 348(29.2%)patients did after 72 hours;The most frequent type of esophageal foreign bodies was plants(448 cases,37.6%),followed by animalia(403 cases,33.9%),metallic(200 cases,16.8%)and synthetic(139 cases,11.7%),with jujube pits,chicken bones and coins accounting for 62.9%(750 cases)of all;The number of location of entrapment was 827(69.5%)cases near the first esophageal physiological narrow,245 cases(20.6%)at the upper part,93 cases(7.8%)at the middle and lower parts and 25 cases(2.1%)at others;We treated 1088(91.4%)patients only by endoscopy,41(3.4%)patients by surgery and 61(5.2%)by other methods;The length of stay ranged from 1 day to 71 days(mean: 5.9 ± 4.9 days;median: 5 days);1180(99.2%)patients got complete recovery.A group comparison of 1069 patients treated only by endoscopy and 41 patients by surgery with exact foreign bodies,There were statistical differences between the two groups in the age,treatment time,type of foreign body and incarceration group.CONCLUSIONEsophageal foreign body is one of the most commonly in gastrointestinal emergency disease,the incidence of male and female basically in the same level,the department of otorhinolaryngology head and neck surgery is the chief firsted-visited palce among our hospital,and patients who under surgical treatment is most commonly in department of thoracic surgery.The most frequent type of esophageal foreign bodies is the jujube pits,chicken boons as well as coins,and nearby of the first esophageal physiological narrow is the most commonly place of occurrence.Standardized diagnosis and treatment are important.Esophageal foreign bodies should be taken out within 24 hours.The correction of water and electrolyte disturbance immediately,the usage of enteral and parenteral nutrition sustain,anti-acid and esophagel mucosa protection drugs,effective antibiotic therapy and temporary esophageal exclusion if necessary,all are beneficial to the patients’ better recovery.