Endoscopic Management Of Foreign Bodies In The Upper Gastrointestinal Tract

BackgroundForeign bodies in the upper digestive tract refers to any object in the upper digestive tract that was originated outside the body which can't be digested or excreted in time.It's one of the common clinical emergencies,and it's accounts for4%of emergency endoscopic diagnosis and treatment^[1,2].If the treatment is not timely,it may cause many complications such as upper gastrointestinal obstruction,mucosal injury,perforation,bleeding,infection,etc.In severe cases,it may even cause septic shock,esophagotracheal fistula,aortic rupture,etc.,which may endanger the patient's life.According to the literature,about 1,500 people die each year from foreign bodies in the upper digestive tract in America.The current treatment methods of foreign bodies in the upper digestive tract mainly include natural elimination,endoscopic treatment and surgical operation.In western countries,the vast majority?80-90%?of digestive tract foreign bodies are excreted naturally,10%-20%need endoscopic treatment,and about 1%of patients need surgical treatment.The types of foreign bodies in the upper digestive tract in China are different from those in western countries,so the proportion of endoscopic treatment is higher.Endoscopic therapy is the primary treatment for Foreign bodies in the upper digestive tract.Compared with traditional surgery,endoscopic therapy has the advantages of less trauma,less complications,faster recovery and lower cost,and has the dual value of diagnosis and treatment.In addition,with the development of digestive endoscopy technology,endoscopic treatment may be achieved in patients who previously required surgical management.ObjectiveAnalyzing the clinical features of cases with foreign bodies in the upper gastrointestinal tract treated by digestive endoscopy,evaluating the security and effectiveness of therapeutic endoscopy,and concluding the methods and experience.MethodsCollecting 168 cases with foreign bodies in the upper gastrointestinal tract who did therapeutic endoscopy in our hospital during 2017.9.1 to 2018.9.1.ResultsForeign bodies in the upper digestive tract occurred high frequency in elderly?45.8%?,most of foreign bodies located in esophageal?78.0%?,date stones is the main type of foreign bodies?56.1%?,the success rate of therapeutic endoscopy is98.2%,53.6%of the cases were discovered complications,none of them was caused by endoscopy,and 97%of them were cured by internal medicine treatment.Complications is related to age?location and type of the foreign bodies.19.05%of the cases had related disease,the rate is higher in elderly.While extracting foreign bodies,we can do other operations such as biopsy?debride?hemostasis?POEM and stenosis dilatation.ConclusionsTherapeutic endoscopy is the most significant method treating foreign bodies in the upper gastrointestinal tract,it has great security and effectiveness,meanwhile,it has great value for discovering invisible diseases and treating primary diseases or complications.In addition,with the development of digestive endoscopy technology,endoscopic treatment may be achieved in patients who previously required surgical management.