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R Kochhar R Aggarwal M K Goenka S Mehta S K Mehta 《Indian journal of gastroenterology》1990,9(4):283-284
Records of 55 consecutive patients who had ingested foreign bodies were reviewed retrospectively. Foreign bodies were located in the esophagus, stomach and duodenum in 25, 27 and 3 patients respectively. Eleven of these passed through the entire gastrointestinal tract spontaneously and uneventfully. Endoscopic extraction was successful in 36 patients while 8 needed surgical removal of the ingested object. Only one death was encountered. We conclude that using simple guidelines, foreign body ingestion can be managed with a low incidence of complications and mortality. 相似文献
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Management of foreign bodies of the upper gastrointestinal tract 总被引:6,自引:0,他引:6
W A Webb 《Gastroenterology》1988,94(1):204-216
In the United States, 1500 people die yearly of ingested foreign bodies of the upper gastrointestinal tract. The flexible esophagogastroduodenoscope has had a major impact on the treatment of these foreign bodies. The following discussion includes the management of coins, meat impaction, sharp and pointed objects, button batteries, and cocaine packets; and it reflects both a personal experience and a review of the literature. The uses of the rigid and the flexible endoscopes, the Foley catheter, glucagon, papain, and gas-forming agents are presented. The cost-effectiveness impact of the flexible endoscope is also detailed, and morbidity and mortality rates for foreign body management are included. 相似文献
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目的 积累内镜下处理复杂上消化道异物的经验.方法 分析我院2000年2月~2010年2月对67例复杂上消化道异物内镜处理情况.结果 67例患者中共有87件异物,其中有58例74件异物经内镜成功取出,尚有9例13件异物未取出.取出异物例数成功率为86.57%,取出异物件数成功率为85.06%,未出现严重并发症.结论 内镜下取复杂上消化道异物安全、有效. 相似文献
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Choichi Sugawa Hiromi Ono Mona Taleb Charles E Lucas 《World journal of gastrointestinal endoscopy》2014,6(10):475-481
Foreign body ingestion is a common condition, es-pecially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batter-ies. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with mini-mal complications. This review describes a comprehen-sive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experi-ence. 相似文献
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郑斯杰 《中国实用内科杂志》2011,(10):791-792
食管、胃内异物是常见的急症,常引起食管、胃黏膜损伤,甚至引起大出血、上消化道穿孔等严重并发症。经内镜取上消化道异物简便、创伤小、成功率高,其已作为治疗上消化道异物的首选方法[1]。现将我院内镜下取上消化道异物的体会总结如下。 相似文献
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目的 探讨一种新型内镜扩张球囊取出上消化道异物的安全性并评估其疗效.方法 收集2018年7 月至2019年3 月收治于苏州大学附属第一医院经传统方法取出失败的10例上消化道异物患者的临床资料,其中食管异物8例,胃石2例,内镜扩张球囊辅助胃镜取出异物,观察操作成功率、异物取出所用时间、视野清晰度、黏膜损伤及并发症等情况.... 相似文献
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Foreign bodies of the upper gastrointestinal tract 总被引:3,自引:0,他引:3
This is a retrospective review of our experience with fiberendoscopic management of 40 separate episodes of foreign body ingestion. Eighteen patients swallowed a food bolus which impacted in the esophagus. Seventy-eight percent of these patients had an esophageal stenosis. Sixteen patients were involved in 22 episodes of true foreign body ingestion. Fiberendoscopic management was successful in 92% of food impactions and 76% of true foreign bodies. In our experience, fiberendoscopic removal is a safe procedure with an 83% overall success rate. It is the method of choice in the management of esophageal and gastric foreign bodies. 相似文献
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Chong Geng Xiao Li Rong Luo Lin Cai Xuelian Lei 《Scandinavian journal of gastroenterology》2017,52(11):1286-1291
Objective: To report our endoscopic outcomes and explore the effects of duration of impaction and anesthetic methods on the endoscopic removal of foreign bodies in the upper gastrointestinal tract.Methods: All consecutive patients with suspected foreign body (FB) ingestion between January 2013 and June 2016 were enrolled. Demographic, clinical and endoscopic data were collected and analyzed.Results: A total of 1294 patients aged seven months to 94 years were enrolled. Odynophagia (415 cases, 32.1%), FB sensation (340 cases, 26.3%) and sore throat (267 cases, 20.1%) were the most frequent complaints. The duration of FB impaction ranged from 4?h to over two years. Anatomically, foreign bodies were most commonly located in the esophagus (n?=?1025, 86.9%). Bony foreign bodies comprised the majority of identified foreign bodies. The most common underlying pathology was esophageal stricture (38 cases, 53.5%). Nearly half of the patients (49.9%) developed complications. As the duration of impaction increased, the success rate by endoscopy decreased (p?.001), and the complication rate increased (p?.001). Endoscopic management under general anesthesia didn’t improve the success rate or lower the complication rate compared with topical pharyngeal anesthesia (p?=?.793 and p?=?.085). Age?≥60, duration of impaction longer than one day, impaction in the esophagus, and sharp foreign bodies were identified as risk factors for complications.Conclusions: Delayed flexible endoscopy in patients, especially elderly patients, with sharp FB impactions in the esophagus results in worse endoscopic outcomes. Endoscopic management under general anesthesia did not improve the therapeutic results compared with topical pharyngeal anesthesia. 相似文献
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Chiu YH Hou SK Chen SC How CK Lam C Kao WF Yen DH Huang MS 《The American journal of the medical sciences》2012,343(3):192-195
IntroductionThe objective is to evaluate the diagnosis of foreign body (FB) ingestion and report on the endoscopic management in Taiwan.MethodsThis retrospective study enrolled 159 adult patients with confirmed diagnosis of upper gastrointestinal FBs who received endoscopic management in the emergency department.ResultsThe patients’ mean age was 57.0 ± 19.2 years, and 66 (37.7%) of the patients were 65 years or older. Majority had a clear history and symptoms of FB ingestion. However, 9 (5.7%) initially ignored the accidental swallowing of FBs and were diagnosed late. The mean time spent for diagnosis was 1.8 days in those with uncertain history. Only 47.1% of those with radiographic studies had positive findings. Fish bones, press-through package and dentures were the most common culprits in this population of Asian elderly. Majority of FBs were located in the esophagus, especially in the upper third. Endoscopic FB extraction was successful in 96.9% of cases, while surgery was required in only 5 patients. The complication rate was 6.9%, including mucosal laceration (n = 10) and suspected perforation (n = 1), all of which were successfully managed conservatively. There was no death due to FB ingestion or endoscopy.ConclusionsIn FB ingestion, history usually points toward the diagnosis. Patients with an uncertain history are usually diagnosed late, and plain radiography cannot reliably predict the presence of FB. Endoscopic management is safe and effective for FBs. 相似文献
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Kyong Hee Hong Yoon Jae Kim Jae Hak Kim Song Wook Chun Hee Man Kim Jae Hee Cho 《World journal of gastroenterology : WJG》2015,21(26):8125-8131
AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract.METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract,confirmed by endoscopy,at two university hospital in South Korea.Patient demographic data,including age,gender,intention to ingestion,symptoms at admission,and comorbidities,were collected.Clinical features of the foreign bodies,such as type,size,sharpness of edges,number,and location,were analyzed.Endoscopic data those were analyzed included duration of foreign body impaction,duration of endoscopic performance,endoscopic device,days of hospitalization,complication rate,30-d mortality rate,and the number of operationsrelated to foreign body removal.RESULTS: The types of upper gastrointestinal foreign bodies included fish bones,drugs,shells,meat,metal,and animal bones.The locations of impacted foreign bodies were the upper esophagus(57.2%),mid esophagus(28.4%),stomach(10.8%),and lower esophagus(3.6%).The median size of the foreign bodies was 26.2 ± 16.7 mm.Among 194 patients,endoscopic removal was achieved in 189,and complications developed in 51 patients(26.9%).Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding(n = 31,16%),ulcer(n = 11,5.7%),perforation(n = 3,1.5%),and abscess(n = 1,0.5%).Four patients underwent operations because of incomplete endoscopic foreign body extraction.In multivariate analyses,risk factors for endoscopic complications and failure were sharpness(HR = 2.48,95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction(HR = 2.42,95%CI: 1.12-5.25,P = 0.025).CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects,rapid endoscopic intervention should be provided in patients with ingested foreign bodies. 相似文献
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目的 系统评价国内上消化道嵌顿异物内镜取出失败的影响因素.方法 用循证医学方法,检索中文数据库中有关内镜取上消化道异物的文献并获取全文,根据严格的纳入和排除标准对文献进行筛选,从1975年至2010年10月共纳入215项研究(共904例取出失败),均为回顾性队列研究.然后对入选文献进行数据提取、汇总及归纳分析.结果 结果显示内镜下取金属类异物的失败率较高(23.0%,78/371);异物吞入24h之后内镜取出失败的比例(97.5%,79/81)明显高于24h内取出失败的比例(2.5%,2/81);内镜下取嵌顿于食管的异物的失败率(49.8%,213/428)较胃(29.0%,124/428)、十二指肠(17.0%,73/428)、会厌部(4.2%,18/428)的失败率高;特殊人群(被管制人员、精神心理异常患者)较一般患者失败率高[(8.4%,29/346)比(4.2%,875/21071),P=0.0001).术前行胸腹部X线检查和CT检查病例的失败率(3.7%,22/591)低于只行胸腹部X线检查(4.3%,788/18450)或钡餐检查(5.1%,50/980)的失败率.失败患者中有9例死亡病例,均为锐利骨类异物的嵌顿,8例嵌顿于食管中上段,6例嵌顿时间超过24h.结论 异物类型、大小、嵌顿时间、所处消化道位置以及患者的人群特点与内镜下取异物失败率的高低有关.做好充分的术前准备、加强特殊人群管理,改善饮食习惯,及时就诊是控制失败率的关键. 相似文献
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张秋英 《胃肠病学和肝病学杂志》2011,20(11):1060-1062
原发性食管合外十二指肠球邸恶性黑色素瘤临床较为罕见,为探讨其病理特征、临床诊断及治疗而避免误诊误治,报道1例上消化道恶性黑色素瘤。上消化道黑色素瘤恶性程度高,预后不良,治疗以根治手术切除为主,辅以放疗。 相似文献
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Guideline for the management of ingested foreign bodies 总被引:40,自引:0,他引:40
Eisen GM Baron TH Dominitz JA Faigel DO Goldstein JL Johanson JF Mallery JS Raddawi HM Vargo JJ Waring JP Fanelli RD Wheeler-Harbough J;American Society for Gastrointestinal Endoscopy 《Gastrointestinal endoscopy》2002,55(7):802-806
This is one of a series of statements discussing the utilization of gastrointestinal endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations. 相似文献
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上消化道异物内镜急诊处理162例 总被引:3,自引:0,他引:3
目的:探讨上消化道异物内镜下急诊诊断及取出的处理方式.方法:2002-07/2011-07龙岗区第二人民医院胃镜室共完成内镜下急诊异物取出上消化道异物患者162例,男89例,女73例,年龄0.8-82岁,异物吞入后就诊时间为3min-9d,分析患者临床资料.结果:采用局麻或全麻下急诊用内镜直视下明确诊断,按照异物的位置、形态、大小、选择合适的器械,取出异物或设法让异物通过肠道排出体外.162例患者中155例通过上述方法治疗后取得满意疗效,7例患者治疗失败后改为手术处理,内镜下急诊取出治疗上消化道异物成功率为95.7%,部分并发咽喉黏膜损伤.结论:经内镜局麻或全麻下急诊取出上消化道异物是一种安全、有效的方法;手法得当,用内镜上消化道异物急诊取出应为首选方法,有器质性病变的患者取出异物后应尽早病因治疗. 相似文献