Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency

Tseng, Chia‐Cheng; Hsiao, Tzu‐Yu; Hsu, Wei‐Chung

doi:10.1016/j.jfma.2015.05.016

Cited by 26 publications

(24 citation statements)

References 24 publications

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“…The fact that physiologically lacking of teeth and swallowing disorders occur with the increase in age may contribute to the high risk of FB ingestion in elderly patients. 7,15,16 And the custom of talking while eating may be the direct trigger. Moreover, age >50 to 60 years was identified as a risk factor for complications in several studies.…”

Section: Discussionmentioning

confidence: 99%

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

et al. 2020

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Objectives: To propose a management algorithm for adult patients with sharp-pointed esophageal foreign-body impaction (EFBI) who have rigid endoscopy (RE) indications and to conduct a retrospective analysis of their data. Methods: All adult patients who received RE at the Department of Otorhinolaryngology in Beijing Shijitan Hospital between January 2017 and May 2019 were enrolled. The demographics, clinical characteristics, and management data were collected and analyzed. Results: A total of 130 patients were identified, 56.9% were female with median age 60 years. More than half (56.9%) of patients had foreignbody (FB) ingestion on holidays. The most frequent FBs were jujube pits (66.9%) and bones (23.8%). There is a significant female predominance in ingestion of jujube pits (65.5%, P ¼ .005). The most common symptoms were odynophagia (49.2%) and sore throat (47.7%). The majority (96.8%) of FB founded were lodged at upper esophagus. In all, 74 patients were categorized as having mild complications and 54 having significant complications. Time interval from ingestion to presentation longer than 15 hours was an independent risk factor for significant complications, while esophagogram with barium as a protective factor. Conclusions: Long-time interval from ingestion to presentation will lead to high risk of significant complications. Computed tomography should be a prioritized imaging method for all patients suspected with EFBI, and multidisciplinary collaboration is recommended. Besides, mass education on eating habits is necessary.

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Section: Discussionmentioning

confidence: 99%

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

et al. 2020

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“…It is important to note that in some series for a fraction of patients (24%) who applied to the emergency departments with foreign body ingestion or food impaction, the object could not be identified using endoscopy. [15] If the object is radiolucent, it is almost invisible in radiographs. The lump sensation, odynophagia, or dysphagia could persist for a short time due to the irritation of mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…Rigid endoscopy is preferably used for the removal of foreign body from the esophagus in some eastern clinical practices with high success rates and low complica-tions. [15,16] The authors have advocated that rigid endoscopy is more appropriate for proximal esophagus and more advantageous to remove the bigger chunks of food or foreign body due to the wider lumen for manipulation. However, some studies have claimed that the procedural duration is longer in rigid endoscopy compared to flexible and that the latter provides better examination of the esophageal mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…[17] The complication rates in eastern practices did not differ between rigid and flexible endoscopies, which is possibly attributed to the experience of performing physicians or the variations in the foreign body. [15] We preferred not to use rigid endoscopies (only in 11 patients) because of the general anesthesia requirements and patient discomfort compared to flexible endoscopy. Moreover, it has been shown previously that rigid endoscopy is associated with increased complication rates, less patient comfort, increased dysphagia, and general anesthesia requirements.…”

Section: Discussionmentioning

confidence: 99%

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Foreign Body Ingestion and Food Impaction Management in Adults: A Cross-sectional study

Okan

Akbaş

Küpeli

et al. 2018

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The management of food impaction and foreign body ingestion in the upper gastrointestinal tract requires careful evaluation and timely intervention. This study was a retrospective evaluation of the management of adult patients with such a history. METHODS: This study included adult patients admitted to a tertiary medical center with foreign body ingestion or food impaction between January 2012 and January 2018. The demographic and clinical data were recorded pro forma for statistical analysis. RESULTS: Of the 122 patients included in this study, 53.2% were male, and the mean age was 46.68±18.64 years. In 84 of the patients (68.8%), the ingested object was food. Thirty patients were managed solely through laryngoscopy, while 61 patients (50%) underwent a flexible endoscopy. The patients with a foreign body ingestion were older than those with a food impaction (mean age: 51.3±17.4 vs. 36.5±17.4 years; p<0.001) and a plain radiograph showed the ingested material more often in those patients (36.8% vs 10.7%; p<0.001). Two patients underwent surgery due to perforations caused by the impacted material. No mortality was observed. CONCLUSION: The management of a foreign body ingestion or food impaction in an emergency setting requires a stepwise, algorithmic approach.

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“…Removal of FB was mainly performed by rigid and exible endoscopy according to the localization of the FB and symptoms of the patient and was successful in 81% and 90%, respectively. High success rates for rigid and exible endoscopy have been reported in retrospective studies for oesophageal FB in children and adults with low rate of complications [12,36,42,43]. The management of foreign body, food and toxic substance ingestions needs to be adapted for infants, e.g.…”

Section: Ingestion Of Foreign Bodies or Chemical Substances Is Frequementioning

confidence: 99%

Increase of foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017

Speidel

Woelfle

Mayer

et al. 2020

Preprint

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Background Children with a history of caustic or foreign body ingestions (FBI) are frequently presented at the emergency department. An uncertain case history, the different objects and diverse clinical presentation may complicate or delay a proper management and cause serious complications. Methods A structured retrospective data analysis of patients presented in between January 2005 and December 2017 at the University Medical Centre Ulm was performed. All patients up to 17 years of age with food impaction, foreign body or harmful substance ingestion were included by selection of the corresponding International Statistical Classification of Diseases and Related Health Problems (ICD10-GM) codes. Descriptive statistics, parametric or non-parametric tests, and linear regression analysis were performed. Result In total, 1199 cases were analysed; mean age 3.3 years (SD 3.12; range 7 days to 16 years), male to female ratio 1.15:1, thereof 194 (16.2%) were hospitalized. The majority (n = 619) had no symptoms, 244 out of 580 symptomatic patients complained retching or vomiting. The annually recorded cases increased from 66 in 2005 to 119 in 2017 with a rise of the percentage of all emergency cases by 0.52% since 2010 to 1.34% in 2017. Most frequently, coins were ingested (18,8%). Radiopaque objects accounted for 47.6%, and sharp objects for 10.5% of the FBI, which were significantly more often ingested by girls (p < 0.000015 and p < 0.000024, respectively). Button battery ingestion was recorded in 63 cases with a significant annual increase (R2 = 0.57; beta = 0,753; p < 0.003). The annual rate of complications raised significantly (R2 = 0.42; beta = 0,647; p < 0.017). Conclusion Children with FBI are increasingly presented at emergency departments. Special attention is necessary to prevent serious complications, especially in asymptomatic children. Further preventive measures within the home environment are needed to stop this trend.

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Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency

Cited by 26 publications

References 24 publications

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

Foreign Body Ingestion and Food Impaction Management in Adults: A Cross-sectional study

Increase of foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017

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