Study on clinical treatment of severe complications caused by esophageal foreign bodies
Zhang Yongxia1, Qi Jixia2,3, Chen Liwei1,3, Zhao Jiandong1, Han Mingkun1,3, Li Jianhui3, Li Xinjian3, Zong Liang1, Wu Wenming1, Wang Jialing1, Huang Deliang1, Liu Mingbo1,3
1Deparment of Otorhinolaryngology Head and Neck Surgery, the First Medical Center, Chinese PLA General Hospital, ColIege of Otolaryngology Head and Neck Surgery, National Clinical Research Center for Otolaryngologic Diseases, Key Lab of Hearing Science, Ministry of Education, Beijing Key Lab of Hearing Impairment for Prevention and Treatment, Beijing 100853, China; 2Weifang Medical University Clinical Medicine, Weifang 261053, China; 3Department of Otorhinolaryngology Head and Neck Surgery, Hainan Hospital of PLA General Hospital, the Clinical Medical Research Center for Otolaryngology Head and Neck Diseases of Hainan Province, Sanya 572013, China
Abstract：Objective This study aimed to investigate the treatment strategy of severe complications caused by esophageal foreign bodies.Methods A retrospective analysis was conducted on 23 patients with esophageal foreign body and severe complications, such as esophageal perforation and cervical and chest infections, admitted to the Department of Otolaryngology Head and Neck Surgery of the First Medical Center of People's Liberation Army General Hospital from July 2014 to July 2018. Among the patients, 11 were male and 12 were female, respectively aged from 2 years to 87 years. Among the 23 patients, foreign bodies were located in 16 cases of first esophageal stenosis, four cases of second esophageal stenosis, one case of third stenosis, and two cases of fourth stenosis. The patients in this group were evaluated for the location of foreign bodies, esophageal injury, and peripheral inflammation through preoperative computed tomography scans. Seventeen patients underwent rigid esophageal endoscopic foreign body removal, five patients underwent cervical incision to detect foreign body removal, and one patient underwent open chest exploration for foreign body removal. All patients were treated with comprehensive measures, such as gastrointestinal decompression, anti-infection, and nutritional support.Results All patients in this group successfully completed the operation, and the nasogastric feeding tube was successfully removed after operation and perioperative comprehensive treatment. The wound drainage tube was successfully removed in the patients who underwent lateral cervical incision and thoracotomy. All patients recovered and were discharged from the hospital. One patient experienced concurrent neck segment esophageal stenosis level two after 1-month postsurgery, and line expansion esophagus returned to normal after treatment. After discharge, the patients were followed up for 3-5 months. All the 23 patients received normal diet and exhibited grade 0 esophageal stenosis in accordance with stool classification standard.Conclusions Esophageal foreign bodies with severe complications should be removed in different means. Comprehensive treatment measures, such as perioperative gastrointestinal decompression, anti-infection, and nutritional support are essential. Multidisciplinary rescue is an important measure to save patients' lives.
张永侠, 祁继霞, 陈立伟, 赵建东, 韩明鲲, 李剑挥, 李新建, 纵亮, 武文明, 王嘉陵, 黄德亮, 刘明波. 食管异物合并严重并发症的临床治疗分析[J]. 中华解剖与临床杂志, 2020, 25(5): 527-531.
Zhang Yongxia, Qi Jixia, Chen Liwei, Zhao Jiandong, Han Mingkun, Li Jianhui, Li Xinjian, Zong Liang, Wu Wenming, Wang Jialing, Huang Deliang, Liu Mingbo. Study on clinical treatment of severe complications caused by esophageal foreign bodies. Chinese Journal of Anatomy and Clinics, 2020, 25(5): 527-531.
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2020, Vol. 25 
