Clinical characteristics and risk factors of complications of foreign body incarceration in upper digestive tract_West China Medical Journal

Authors：

YANG Yulan ¹ , YU Anyong ¹ ,  XIE Zhihui ² ,  DUAN Haizhen ¹

1. Department of Emergency, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P. R. China;
2. Department of Hyperbaric Oxygen, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003, P. R. China;

Corresponding author：

XIE Zhihui, Email: xiezhihui71@126.com; DUAN Haizhen, Email: haizhenduan@126.com

Keywords：

Upper digestive tract; foreign bodies; complications; risk factors

DOI：

10.7507/1002-0179.202210195

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze and summarize the clinical characteristics of foreign body incarceration in upper digestive tract, and to explore the risk factors of its complications. Methods The clinical data of patients with foreign bodies in the upper digestive tract treated in the Affiliated Hospital of Zunyi Medical University between January 1, 2012 and December 31, 2021 were retrospectively analyzed, including demographic data, foreign body type, incarceration site, incarceration time, causes, symptoms, treatment methods and complications of foreign body incarceration. Logistic regression analysis was used to explore the risk factors of complications. Results A total of 721 patients were finally included, ranging in age from 3 months to 90 years old, with an average age of 26.76 years. The proportion of foreign bodies in the upper digestive tract in patients ≤14 years old was the highest (51.18%), and the duration of foreign body incarceration<12 hours was the highest (55.34%). The most common sharp foreign bodies in the upper digestive tract were animal bones (228 cases), and the most common round shaped foreign bodies were coins (223 cases). The most common impaction site was the upper esophageal segment (85.02%). 105 patients (14.56%) had complications, and perforation was the most common (5.55%). Logistic regression analysis showed that age [odds ratio (OR)=0.523, 95% confidence interval (CI) (0.312, 0.875), P=0.014], foreign body type [OR=0.520, 95%CI (0.330, 0.820), P=0.005], incarceration site [OR=2.347, 95%CI (1.396, 3.947), P=0.001], incarceration time [OR=0.464, 95%CI (0.293, 0.736), P=0.001] were the influencing factors of complications. Conclusions The majority of foreign bodies in the upper digestive tract are animal bones. The incidence of complications increase in patients with age ≥ 60 years, sharp foreign body edges, incarceration in the upper segment of the esophagus, and long incarceration time. It is recommended to remove the sharp foreign bodies incarcerated in the upper segment of the esophagus from the elderly as soon as possible.

Citation： YANG Yulan, YU Anyong, XIE Zhihui, DUAN Haizhen. Clinical characteristics and risk factors of complications of foreign body incarceration in upper digestive tract. West China Medical Journal, 2022, 37(11): 1630-1635. doi: 10.7507/1002-0179.202210195 Copy

1.	Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr, 2015, 60(4): 562-574.
2.	Erbil B, Karaca MA, Aslaner MA, et al. Emergency admissions due to swallowed foreign bodies in adults. World J Gastroenterol, 2013, 19(38): 6447-6452.
3.	Lešková J, Štichhauer R, Preis J, et al. Foreign body ingestion in children. Rozhl Chir, 2019, 98(9): 370-374.
4.	刘庆华, 梁宏伟, 张雅静. 消化道难取异物经内窥镜取出的手术技巧. 中国医科大学学报, 2003, 32(1): 86-87.
5.	Palta R, Sahota A, Bemarki A, et al. Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion. Gastrointest Endosc, 2009, 69(1): 426-433.
6.	Weiland ST, Schurr MJ. Conservative management of ingested foreign bodies. J Gastrointest Surg, 2002, 6(3): 496-500.
7.	Yuan J, Ma M, Guo Y, et al. Delayed endoscopic removal of sharp foreign body in the esophagus increased clinical complications: an experience from multiple centers in China. Medicine (Baltimore), 2019, 98(26): e16146.
8.	Sung SH, Jeon SW, Son HS, et al. Factors predictive of risk for complications in patients with oesophageal foreign bodies. Dig Liver Dis, 2011, 43(8): 632-635.
9.	Subotic D, Atanasijadis N, Moskovljevic D, et al. Repeated synchronous aspiration and ingestion of a sharp metallic foreign body in a mentally disabled adolescent. Case Rep Surg, 2019, 2019: 1296061.
10.	韩丽军. 强制戒毒人员吞食异物 X 线诊断及临床分析. 中国药物滥用防治杂志, 2012, 18(3): 150,152.
11.	Jia P, Zhang M, Hu L, et al. Cardanol groups grafted on poly(vinyl chloride)-synthesis, performance and plasticization mechanism. Polymers (Basel), 2017, 9(11): 621.
12.	ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc, 2011, 73(6): 1085-1091.
13.	Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy, 2016, 48(5): 489-496.
14.	文静, 殷云勤, 王晶. 太原及周边地区 701 例上消化道异物的临床特点分析. 中国现代医生, 2015, 53(36): 78-81, 85.
15.	任红霞, 陈兰萍, 陈淑芸, 等. 腹腔镜下摘取新生儿消化道巨大异物 1 例. 中国微创外科杂志, 2010, 10(12): 1147-1148.
16.	黄华, 崔晓燕, 张大, 等. 完全腹腔镜手术治疗小儿消化道异物磁力珠 10 例分析. 中国微创外科杂志, 2021(7): 657-660.
17.	林乐. 消化道异物流行病学特点的回顾性分析. 现代医用影像学, 2019, 28(1): 37-40.
18.	Pawa S, Khalifa AJ, Ehrinpreis MN, et al. Zinc toxicity from massive and prolonged coin ingestion in an adult. Am J Med Sci, 2008, 336(5): 430-433.
19.	Wong J, Kovacic K, Lerner D. Esophageal inflammatory fibroid polyp after button battery ingestion. J Pediatr Gastroenterol Nutr, 2021, 73(6): e126.
20.	Rostad BS, Richer EJ, Riedesel EL, et al. Esophageal discoid foreign body detection and classification using artificial intelligence. Pediatr Radiol, 2022, 52(3): 477-482.
21.	张生, 侯崇智, 施伟栋, 等. 儿童误吞磁性异物引起消化道穿孔 30 例临床分析. 中国妇幼健康研究, 2021, 32(11): 1666-1671.
22.	Zhang S, Cui Y, Gong X, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract in South China: a retrospective study of 561 cases. Dig Dis Sci, 2010, 55(5): 1305-1312.
23.	Emara MH, Darwiesh EM, Refaey MM, et al. Endoscopic removal of foreign bodies from the upper gastrointestinal tract: 5-year experience. Clin Exp Gastroenterol, 2014, 7: 249-253.
24.	Longstreth GF, Longstreth KJ, Yao JF. Esophageal food impaction: epidemiology and therapy. a retrospective, observational study. Gastrointest Endosc, 2001, 53(2): 193-198.
25.	Gmeiner D, von Rahden BH, Meco C, et al. Flexible versus rigid endoscopy for treatment of foreign body impaction in the esophagus. Surg Endosc, 2007, 21(11): 2026-2029.
26.	张红, 叶少松, 王彦宏, 等. 消化道异物并穿孔的危险因素分析及治疗策略. 第三军医大学学报, 2022, 44(4): 379-384.
27.	He S, Zuo ZL. Different anatomical sites of the foreign body injury with 2999 children during 2012-2016. Chin J Traumatol, 2018, 21(6): 333-337.
28.	Lee CY, Kao BZ, Wu CS, et al. Retrospective analysis of endoscopic management of foreign bodies in the upper gastrointestinal tract of adults. J Chin Med Assoc, 2019, 82(2): 105-109.
29.	Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology, 2017, 65(1): 310-335.
30.	王跃生, 张敬, 李小芹, 等. 儿童上消化道异物所致并发症及其危险因素分析. 中国当代儿科杂志, 2020, 22(7): 774-779.
31.	陈怡, 卓琳, 孔祥歆, 等. 儿童上消化道异物并发损伤的危险因素分析. 临床急诊杂志, 2022, 23(1): 61-66.
32.	朱泱蓓, 柏愚, 邹多武, 等. 中国上消化道异物内镜取出失败的系统评价. 中华消化内镜杂志, 2012, 29(6): 332-335.
33.	刘小刚, 杜夏, 冯义朝, 等. 上消化道异物的特点及其并发症的危险因素分析. 中国内镜杂志, 2018, 24(5): 63-67.

1. Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr, 2015, 60(4): 562-574.
2. Erbil B, Karaca MA, Aslaner MA, et al. Emergency admissions due to swallowed foreign bodies in adults. World J Gastroenterol, 2013, 19(38): 6447-6452.
3. Lešková J, Štichhauer R, Preis J, et al. Foreign body ingestion in children. Rozhl Chir, 2019, 98(9): 370-374.
4. 刘庆华, 梁宏伟, 张雅静. 消化道难取异物经内窥镜取出的手术技巧. 中国医科大学学报, 2003, 32(1): 86-87.
5. Palta R, Sahota A, Bemarki A, et al. Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion. Gastrointest Endosc, 2009, 69(1): 426-433.
6. Weiland ST, Schurr MJ. Conservative management of ingested foreign bodies. J Gastrointest Surg, 2002, 6(3): 496-500.
7. Yuan J, Ma M, Guo Y, et al. Delayed endoscopic removal of sharp foreign body in the esophagus increased clinical complications: an experience from multiple centers in China. Medicine (Baltimore), 2019, 98(26): e16146.
8. Sung SH, Jeon SW, Son HS, et al. Factors predictive of risk for complications in patients with oesophageal foreign bodies. Dig Liver Dis, 2011, 43(8): 632-635.
9. Subotic D, Atanasijadis N, Moskovljevic D, et al. Repeated synchronous aspiration and ingestion of a sharp metallic foreign body in a mentally disabled adolescent. Case Rep Surg, 2019, 2019: 1296061.
10. 韩丽军. 强制戒毒人员吞食异物 X 线诊断及临床分析. 中国药物滥用防治杂志, 2012, 18(3): 150,152.
11. Jia P, Zhang M, Hu L, et al. Cardanol groups grafted on poly(vinyl chloride)-synthesis, performance and plasticization mechanism. Polymers (Basel), 2017, 9(11): 621.
12. ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc, 2011, 73(6): 1085-1091.
13. Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy, 2016, 48(5): 489-496.
14. 文静, 殷云勤, 王晶. 太原及周边地区 701 例上消化道异物的临床特点分析. 中国现代医生, 2015, 53(36): 78-81, 85.
15. 任红霞, 陈兰萍, 陈淑芸, 等. 腹腔镜下摘取新生儿消化道巨大异物 1 例. 中国微创外科杂志, 2010, 10(12): 1147-1148.
16. 黄华, 崔晓燕, 张大, 等. 完全腹腔镜手术治疗小儿消化道异物磁力珠 10 例分析. 中国微创外科杂志, 2021(7): 657-660.
17. 林乐. 消化道异物流行病学特点的回顾性分析. 现代医用影像学, 2019, 28(1): 37-40.
18. Pawa S, Khalifa AJ, Ehrinpreis MN, et al. Zinc toxicity from massive and prolonged coin ingestion in an adult. Am J Med Sci, 2008, 336(5): 430-433.
19. Wong J, Kovacic K, Lerner D. Esophageal inflammatory fibroid polyp after button battery ingestion. J Pediatr Gastroenterol Nutr, 2021, 73(6): e126.
20. Rostad BS, Richer EJ, Riedesel EL, et al. Esophageal discoid foreign body detection and classification using artificial intelligence. Pediatr Radiol, 2022, 52(3): 477-482.
21. 张生, 侯崇智, 施伟栋, 等. 儿童误吞磁性异物引起消化道穿孔 30 例临床分析. 中国妇幼健康研究, 2021, 32(11): 1666-1671.
22. Zhang S, Cui Y, Gong X, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract in South China: a retrospective study of 561 cases. Dig Dis Sci, 2010, 55(5): 1305-1312.
23. Emara MH, Darwiesh EM, Refaey MM, et al. Endoscopic removal of foreign bodies from the upper gastrointestinal tract: 5-year experience. Clin Exp Gastroenterol, 2014, 7: 249-253.
24. Longstreth GF, Longstreth KJ, Yao JF. Esophageal food impaction: epidemiology and therapy. a retrospective, observational study. Gastrointest Endosc, 2001, 53(2): 193-198.
25. Gmeiner D, von Rahden BH, Meco C, et al. Flexible versus rigid endoscopy for treatment of foreign body impaction in the esophagus. Surg Endosc, 2007, 21(11): 2026-2029.
26. 张红, 叶少松, 王彦宏, 等. 消化道异物并穿孔的危险因素分析及治疗策略. 第三军医大学学报, 2022, 44(4): 379-384.
27. He S, Zuo ZL. Different anatomical sites of the foreign body injury with 2999 children during 2012-2016. Chin J Traumatol, 2018, 21(6): 333-337.
28. Lee CY, Kao BZ, Wu CS, et al. Retrospective analysis of endoscopic management of foreign bodies in the upper gastrointestinal tract of adults. J Chin Med Assoc, 2019, 82(2): 105-109.
29. Garcia-Tsao G, Abraldes JG, Berzigotti A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology, 2017, 65(1): 310-335.
30. 王跃生, 张敬, 李小芹, 等. 儿童上消化道异物所致并发症及其危险因素分析. 中国当代儿科杂志, 2020, 22(7): 774-779.
31. 陈怡, 卓琳, 孔祥歆, 等. 儿童上消化道异物并发损伤的危险因素分析. 临床急诊杂志, 2022, 23(1): 61-66.
32. 朱泱蓓, 柏愚, 邹多武, 等. 中国上消化道异物内镜取出失败的系统评价. 中华消化内镜杂志, 2012, 29(6): 332-335.
33. 刘小刚, 杜夏, 冯义朝, 等. 上消化道异物的特点及其并发症的危险因素分析. 中国内镜杂志, 2018, 24(5): 63-67.

West China Medical Journal

Clinical characteristics and risk factors of complications of foreign body incarceration in upper digestive tract

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content