成人食管异物阻塞的诊断与治疗

Diagnosis and treatment of adult esophageal foreign body ingestion

食管异物阻塞是临床常见的急症,好发于儿童,成人食管异物发生率较低,多发生于智力障碍或牙齿缺如的人群。临床多表现为突发的吞咽困难、胸痛等症状。绝大多数的食管异物可自行排除,约20%的异物需要通过内镜的方式取出,只有不到1%的食管异物内镜无法取出,或者内镜取出风险过高需外科手术取出。食管异物如果诊断及时、处理得当很少引起严重并发症,如不能及时诊断或治疗方式不正确可引起食管穿孔甚至死亡。本文主要对成人食管异物阻塞的诊断与治疗做一综述。

Foreign body ingestion is common in emergency. The vast majority of foreign body ingestion occurs in the pediatric population as well as mentally impaired and edentulous adults. The typical clinical manifestation of foreign body ingestion includes acute onset of dysphagia and chest pain. Most of the ingested foreign bodies pass without the need of intervention;however, about 20% of esophageal foreign body ingestion requires endoscopic removal. While less than1% will need surgery for foreign body extraction. Timely diagnosis and proper treatment are associated with low mortality and morbidity rate, while delayed diagnosis and improper treatment always lead to severe complications such as esophageal perforation and death. This article reviews the diagnosis and treatment of adult esophageal foreign body ingestion.