Hippokratia 2001, 5 (3): 110-114

S Triaridis, A Triaridis, V Gantsou, K Karagiannidis, I Bennis, Ch Preponis

Abstract

Acute dysphagia due to foreign body impaction in the upper gastrointestina! tract is a common emergency in otolaryngology. The commonest foreign bocdes in the throat are fish bones and occur usually in adults. Mosr of them can be removed under loca! anesthesia at the outpatient clinic. Esophageal foreign bodies occur in children and in elderly patients. The commonest objects impacted in the esophagus are coins in small children, and food boluses in elderly patients. Adult patients with a history of food bolus impact??n lacking sharp bones can be treated initially with spasmolyt?c drugs, which will relax the esophagus and perm?t the passage of the bolus. If there is sharp object or bone, an esophagoscopy is required. Although diagnosis is main!y based on history, latera! soft tissue of the neck, chest radiographs and contrast swallow, are useful to confirm the diagnosis and to locare the site of obstrucrion.
In this retrospective srudy we included 468 patienrs who presented in the ??? department of' our hospital with foreign bodies of the upper gastrointestinal tract, from December 1998 to December 2000. Eighty six (18.4 %) were ederly patienrs. The majority of the foreign bodies in these patienrs were removed under local anesthesia. Eleven elderly patients were admitted, spontaneous disimpaction of the bolus occurred in three of them and the remaining eight patients underwent rigid esophagoscopy. Out of the 128 esophagoscopies for foreign body rcmoval perf?rmed in our deparrment during the last decade, 32 (25%), were perf?rmed in elderly paricnrs and food bolus was the commonst impacted object (59.4%).

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