Esophageal foreign bodies in adults: systematic review of the literature

Aiolfi, Alberto; Ferrari, Davide; Riva, Carlo Galdino; Toti, Francesco; Bonitta, Gianluca; Bonavina, Luigi

doi:10.1080/00365521.2018.1526317

Cited by 57 publications

(81 citation statements)

References 73 publications

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“…Previous studies demonstrate that patients >80 years are more likely to have FB ingestion. 7 In this cohort, age distribution was approximately normal distribution, with peak between 55 and 65 years. 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.…”

Section: Discussionmentioning

confidence: 66%

“…And about two-thirds or more EFBI lodge at the upper esophagus, especially at the level of the cricopharyngeal sphincter, which is the most narrowing area. 7,33,34 In this cohort, 96.8% of FBs lodged at upper esophagus, among which two-thirds located around the cricopharyngeal sphincter. The higher proportion is mainly because of the multidisciplinary collaboration following the procedure in Figure 1.…”

Section: Discussionmentioning

confidence: 79%

“…13,25 A systematic review including 13 092 patients all over the world revealed sharp-pointed FB (38.1%) as the most common FB. 7 The conflicting results may be owing to various social, cultural, economic, and religious factors in different regions. Take China, for example, the most common type of FB is fish bones in south China and coastal provinces, in contrast with jujube pits in north China.…”

Section: Discussionmentioning

confidence: 99%

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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: 66%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

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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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“…In adults, most ingested foreign bodies pass spontaneously 1,17 ; however, 10-20% of EFB ingestion cases require medical intervention 8 . Previous studies focused on the impaction site, type of EFB, chief complaints, DOI, management, and complications 18 . Few studies divided EFBs into different shapes, such as sharp or blunt EFBs 19 ; when they did so, such classification was general and inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Retrospective observational analysis of esophageal foreign bodies: a novel characterization based on shape

Ruan

Yu-ning

Feng

et al. 2020

Sci Rep

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this single-center retrospective study aims to investigate the clinical features of esophageal foreign bodies (EFBs) and determine the influence of EFB shapes on management and prognosis. A total of 427 patients aged 13 to 95 years with suspected EFB ingestion were enrolled between January 2013 and June 2018, 183 of whom were male. EFBs were divided into six shapes: pin (n = 161), sheet (n = 97), trident (n = 51), spindle (n = 66), irregular (n = 46), and sphere (n = 6). Spindle-shaped EFBs correlated with a significantly higher rate of perforation and severe complications (P < 0.001 and P = 0.021, respectively) than any other EFB shape, while sheet-shaped EFBs were linked to less severe complications (P = 0.006). The number of pressure points was provided to stratify the risk of poor prognosis for each shape. EFBs with only two pressure points (pin and spindle EFBs) required more advanced management strategies and were correlated with a higher number of patients suffering esophageal perforation (27.11%) and severe complications (12.44%) when compared with other shapes (χ 2 = 11.149 and P = 0.001; χ 2 = 5.901 and P = 0.015, respectively). Spindle shape was an independent risk factor for poor prognosis, and contributed a more clinical risk than the pin shape. In conclusion, clinical features, management, perforation rate, and severe complications differed based on EFB shape. The EFBs with two pressure points, especially the spindle-shaped EFBs, were more dangerous compared with those with more pressure points. An esophageal foreign body (EFB) is a relatively common complaint in the emergency room. Patients often complain about dysphagia, retrosternal pain, and occasionally abdominal pain prior to being diagnosed with an EFB. An EFB is often accompanied by serious medical conditions, such as cervical abscess, mediastinitis, aortoesophageal abscess, tracheoesophageal fistula, pneumonia, and pneumothorax, most of which are caused by esophageal perforation 1-6. Thus, an EFB can lead to death if the diagnosis is significantly delayed. However, some patients who have ingested foreign bodies do not immediately go to the hospital; instead, they attempt to dislodge EFBs, especially fish bones, by swallowing rice or vinegar 7. This prolongs the time between ingestion and effective treatment and leads the injury to become worse. Thus, it is important to appropriately evaluate the location, size, and shape of the foreign body and provide treatment in an emergency medical situation 8. Types of EFBs may differ among countries and regions according to eating habits, food culture, and sociocultural characteristics 9,10. In Asian countries, fish bones are the most frequent cause of EFBs; whereas, in Western countries, impacted meat is prevalent 11. In addition, many studies report interesting cases of patients ingesting unusual EFBs. For instance, Walton encountered a case that presented with torticollis after ingesting a button battery 12 , and Agrawal reported a case that ingested a metallic magnet with sharp metallic hooks on i...

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“…On the other hand, non-radiopaque FBs can be suspected in the presence of a widened prevertebral shadow, loss of cervical lordosis and radiolucency (air trapping). An emergent endoscopic retrieval of a FB is indicated if a complete obstruction is suspected 2. Pharmacological management of oesophageal soft bolus impaction may be used in selected patients with caution 3…”

mentioning

confidence: 99%