Foreign bodies in the esophagus. A study of causative factors |
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Authors: | Lita Tibbling MD PhD Monika Stenquist |
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Institution: | 1. Department of Otolaryngology, Link?ping University Hospital, Sweden 3. Department of Otolaryngology, Uppsala University Hospital, Sweden
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Abstract: | Two hundred and twenty-nine patients were studied in an attempt to determine the main causative factors behind their having
a residual foreign body in the esophagus. Strictures were present in 13%. Fifty-two percent of the patients with stricture
had been hospitalized more than once for treatment of foreign body impaction; this was the case in only 8.5% of the rest of
the patients (p<0.001). More than half of the patients aged 15 years or younger had a foreign body in the hypopharynx. This location was
extremely uncommon in adults (p<0.001). The hypothesis of spasm distal to an esophageal foreign body as the cause for obstruction in patients without esophageal
stricture was supported by the following findings: spontaneous disimpaction occurred in more than one-third of the patients
and became more frequent as time progressed; 63% of 16 patients given spasmolytic drugs experienced spontaneous disimpaction
of the foreign body; half of the patients had the foreign body in the proximal esophagus distal to the narrower passage of
the upper esophageal sphincter; foreign body impaction in the esophagus turned out to be a once-only event in 86% of the patients;
and 21% of the patients had a disorder of the central nervous system and had been hospitalized significantly more often because
of food impaction than the other patients. The findings indicate that adults with a history of impaction of foodstuff lacking
sharp bones and who do not have stricture suffer food impaction because of spasm of the esophageal smooth muscle, and can
be treated accordingly. |
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Keywords: | Esophagus foreign body Muscle spasm esophageal Spasmolytics Stricture esophageal Deglutition Deglutition disorders |
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