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- Saturday, May 1, 2004
- Food and Foreign Body Impaction In Upper GI Tract
- Published at:Not Found
Food and Foreign Body Impaction In Upper GI Tract
M Yasser F. Abu-SafiehGastrointestinal Endoscopy April 2004 (Vol. 59, Issue 5, Page P242
Background: Ingestion of foreign bodies and food impaction are the most
common cause of esophageal obstruction, which is considered as acute emergency,
this obstruction can be caused by soft, blunt, and sharp objects. Endoscopy is
considered as the main therapeutic procedure, surgical intervention is rarely
needed. Methods: a retrospective study of all patients’ records with acute
esophageal obstruction or presence of radio-opaque foreign body in esophagus or
stomach. Urgent EGD used to be done in outpatient clinic, or elective, if the
patient has the foreign body days in the stomach. XQ10, XV10, and Q20 Olympus
gastroscopes were used, retrieval was carried out by snare or tetrapode grasper,
over tube was used once indicated. Conscious sedation, by using titrated doses of
Medazolam, or GA if sedation was not enough. Patients were classified according
to esophageal pathology, and type of obstructing object. Results: All records of
77patients from 1992-Nov 2003 presented with either esophageal obstruction, or
a radio-opaque shadow were reviewed, mean age 28.2 years ( 1-80 years), total
events 81, M:F 38:39, total number of EGD in that period 4522. Cause of
obstruction, and management were as follows:- (Insert table) * Soft, ** Blunt,
*** Sharp Four patients with gastric bezoars 3 were removed, and one
trichobezoar was fragmented and pushed completely on 3rd sessions. Three pins,
in 3 patients were embedded in full stomach and could not be seen, passed with
stool. The bladewas removed by snare with over tube protection. And in 3 patients
negative EGD. Conclusion: foreign bodies and impacted food can be successfully
managed by gastroscopy in most cases, (93%). Failure is due to embedded bones in
upper esophagus, and surgery is the treatment. Either extracting or pushing
techniques are effective. Coins and coins like impaction occurred in normal
esophagus, mainly in children, while soft bolus impaction occurred in an
abnormally narrowed esophagus.
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