Retrospective Analysis On Foreign Bodies In Upper Gastrointestinal Tract Under Endoscopic Treatment

Background:Relative issues in terms of foreign bodies in upper gastrointestinal tract have been reported in many researches worldwide.The purpose of this study is to have a preliminary retrospective analysis of clinical course of upper gastrointestinal tract foreign bodies in a single large medical center in northern China,and to provide insight into clinical practice of this common condition.Materials and Methods:The present study was conducted retrospectively in Qilu Hospital of Shandong University,Jinan,China from Jan 2012 to Dec 2019.Study included patients admitted for upper gastrointestinal tract foreign bodies.Endoscopic procedures were carried out for the management of foreign bodies.Inclusion criteria:Patients aged 18 and above complaining of foreign body ingestion which was identified with X-ray examination,CT scan or upper gastrointestinal endoscopy were listed.Exclusion criteria:Patients less than 18 with suspected but unidentified ingested foreign bodies were excluded.Statistical analysis:Using SPSS statistics 20.0 to analyze the collected data.categorical data was expressed in frequency.The frequency of data among groups was compared by fisher's exact test,when P value<0.05,the difference was statistically significant,and noting that the P value<0.0167 in any other two age groups and any other two common upper gastrointestinal tract foreign bodies was considered statistically significant.Results:Overall,397 patients with ingested foreign bodies in upper gastrointestinal tract were included in our research.The mean age was 58.39±17.200 years old.All patients were categorized into young(less than 40 years old),middle(40-60 years old)and old(more than 60 years old),age groups.The old age group accounted for the largest proportion(49.9%)of patients,followed by middle age group(34.3%).Of 397 patients,237 patients were diagnosed with common foreign bodies that were jujube seed(41.6%),other animal bone(9.8%)and fish bone(8.3%).The most common lodgment site of foreign bodies in upper gastrointestinal tract occurred at upper-esophagus(67.5%).In current study,fisher's exact test was used indicating a statistic difference of lodgment site.There was statistic defference between old age group and young age group,for old age group the upper-esophagus(71.2%)and mid-esophagus(16.7%)were the sites that foreign bodies commonly ingested at,but for young age group,it was upper-esophagus(61.9%)and stomach(19.0%).in all 297 cases with common ingested foreign bodies,in terms of lodgment site,there was statistic difference between jujube seed and fish bone.Jujube seed commonly ingested at upper-esophagus(78.8%),but fish bone commonly lodged at upper-esophagus(60.6%)and mid-esophagus(36.4%).88.2%of foreign bodies were removed using endoscopy.,and the removal rate in stomach was highest(97.6%).Among the common ingested foreign bodies(jujube seed,other animal bone and fish bone),the removal rate of other animal bone(94.9%)was higher than that of the other two(90.9%and 87.9%respectively).In current study,for easier analysis,erosion,bleeding,ulceration,perforation and infection were regarded as the complications,and all complications that caused by perforation,such as aortic fistula,aortic rupture,were regarded as perforation.The complication rate in all was 61.5%,and the complicaiton rate of erosion was the highest(35.9%),then it was bleeding(31.1%),while the perforation rate was the lowest(0.7%).Noting that the highest complication rate was in mid-esophagus(72.5%),while the stomach and anastomosis had the lower complication rate than esophagus.Conclusion:The jujube seed was the most common type of ingested foreign body in upper gastrointestinal tract in China.Patients over 40 years old should eat less jujube and other fruits with pointed seeds in case of the foreign body ingestion,and patients less than 40 years old should lessen alcohol consumption,decreasing the incidence rate of foreign body ingestion due to the careless eating habits.Further more a minor population of patients who eat foreign bodies intentionally should neutralize and get a control on their mood swings,avoid eating non-dietary objects,etc.For all patients with definite or suspected ingested foreign body,early examinations should be adopted to identify the nature of the ingested foreign body,thus leading to early treatments,and less complications.