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Analysis of Clinical Feature and Management of Fish Bone Ingestion of Upper Gastrointestinal Tract.

Kim JP, Kwon OJ, Shim HS, Kim RB, Kim JH, Woo SH - Clin Exp Otorhinolaryngol (2015)

Bottom Line: The esophageal fish bone was successfully removed by transnasal flexible esophagoscopy (TNE) in 55 patients, the fish bone moved to the stomach in 10 patients and one fish bone was removed by rigid esophagoscopy due to esophageal abscess.The esophageal fish bone was mostly found in patients aged 50 years and older.Fish bone foreign body ingestion in the esophagus appeared to be more common in older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Gyeongsang National University School of Medicine, Jinju, Korea.

ABSTRACT

Objectives: Fish bone impaction in the upper gastrointestinal tract is a common reason for patients to seek emergent care. The aim of this study was to find a clinical characteristics of patients with fish bone impaction in the upper gastrointestinal tract.

Methods: The study was conducted on 286 fish bone ingestion patients who complained of dysphagia and irritation after eating fish. The patients were treated according to the hospital protocol regarding the removal of fish bone. The parameters for the analysis included the age and sex of the patients, location and characteristics of the foreign body, method of removal, and type of fish.

Results: The fish bone could be observed by the physical examination in the oral cavity and laryngopharynx in 198 patients (69.23%). For those patients in whom the foreign body could not be observed in oral cavity and laryngopharynx, noncontrast computed tomography (CT) (from nasopharynx to diaphragm) was performed. The fish bone was discovered in the esophagus of 66 patients (23.08%). The esophageal fish bone was successfully removed by transnasal flexible esophagoscopy (TNE) in 55 patients, the fish bone moved to the stomach in 10 patients and one fish bone was removed by rigid esophagoscopy due to esophageal abscess. The esophageal fish bone was mostly found in patients aged 50 years and older.

Conclusion: Fish bone foreign body ingestion in the esophagus appeared to be more common in older patients. Incorporating noncontrast CT and TNE can facilitate decision-making and adequate treatment for patients with fish bone impactions.

No MeSH data available.


Related in: MedlinePlus

The enrollment of patients. CT, computed tomography; OPD, out patient department; F/U, follow-up; TNE, transnasal esophagoscopy.
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Figure 1: The enrollment of patients. CT, computed tomography; OPD, out patient department; F/U, follow-up; TNE, transnasal esophagoscopy.

Mentions: The study was conducted on fish bone ingestion patients who visited Gyeongsang National University Hospital complaining of dysphagia and irritation after eating fish from December 2010 to August 2012. The study selected 286 patients for whom fish bone foreign bodies in the upper gastrointestinal tract, including the oral cavity and laryngopharynx were suspected (Fig. 1). Examination and treatment were performed according to the foreign body removal protocol (Fig. 2) developed by the hospital. After receiving the patient's consent, we investigated to analyze sex, age distribution, location and type of the fish bone foreign body, endoscopy observations, removal method of the foreign body, and complications after removal. When a fish bone was identified in the oral cavity or laryngopharynx, it was removed using forceps. However a foreign body was suspected in the esophagus, we used noncontrast CT. A radiologic evaluation including the following was performed: Helical CT scan, 3/3 mm slice thickness with images reconstructed at intervals of 1.5 mm, pitch 1.5, without oral or intravenous contrast material. Examination was limited to the upper gastrointestinal area (from the nasopharynx to the diaphragm limits). The CT studies were performed with a CT HiSpeed (GE Medical Systems, Milwaukee, WI, USA).The studies were interpreted as being pathological if a hyperdense body was detected in the esophageal lumen or within/next to the cervical esophageal walls. All these studies were performed and interpreted by a staff radiologist. If the fish bone was visible in noncontrast CT, it was removed using TNE. The EPM-3500 from PENTAX (Tokyo, Japan) was used as the TNE for endoscopic foreign body removal.


Analysis of Clinical Feature and Management of Fish Bone Ingestion of Upper Gastrointestinal Tract.

Kim JP, Kwon OJ, Shim HS, Kim RB, Kim JH, Woo SH - Clin Exp Otorhinolaryngol (2015)

The enrollment of patients. CT, computed tomography; OPD, out patient department; F/U, follow-up; TNE, transnasal esophagoscopy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553358&req=5

Figure 1: The enrollment of patients. CT, computed tomography; OPD, out patient department; F/U, follow-up; TNE, transnasal esophagoscopy.
Mentions: The study was conducted on fish bone ingestion patients who visited Gyeongsang National University Hospital complaining of dysphagia and irritation after eating fish from December 2010 to August 2012. The study selected 286 patients for whom fish bone foreign bodies in the upper gastrointestinal tract, including the oral cavity and laryngopharynx were suspected (Fig. 1). Examination and treatment were performed according to the foreign body removal protocol (Fig. 2) developed by the hospital. After receiving the patient's consent, we investigated to analyze sex, age distribution, location and type of the fish bone foreign body, endoscopy observations, removal method of the foreign body, and complications after removal. When a fish bone was identified in the oral cavity or laryngopharynx, it was removed using forceps. However a foreign body was suspected in the esophagus, we used noncontrast CT. A radiologic evaluation including the following was performed: Helical CT scan, 3/3 mm slice thickness with images reconstructed at intervals of 1.5 mm, pitch 1.5, without oral or intravenous contrast material. Examination was limited to the upper gastrointestinal area (from the nasopharynx to the diaphragm limits). The CT studies were performed with a CT HiSpeed (GE Medical Systems, Milwaukee, WI, USA).The studies were interpreted as being pathological if a hyperdense body was detected in the esophageal lumen or within/next to the cervical esophageal walls. All these studies were performed and interpreted by a staff radiologist. If the fish bone was visible in noncontrast CT, it was removed using TNE. The EPM-3500 from PENTAX (Tokyo, Japan) was used as the TNE for endoscopic foreign body removal.

Bottom Line: The esophageal fish bone was successfully removed by transnasal flexible esophagoscopy (TNE) in 55 patients, the fish bone moved to the stomach in 10 patients and one fish bone was removed by rigid esophagoscopy due to esophageal abscess.The esophageal fish bone was mostly found in patients aged 50 years and older.Fish bone foreign body ingestion in the esophagus appeared to be more common in older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, Gyeongsang National University School of Medicine, Jinju, Korea.

ABSTRACT

Objectives: Fish bone impaction in the upper gastrointestinal tract is a common reason for patients to seek emergent care. The aim of this study was to find a clinical characteristics of patients with fish bone impaction in the upper gastrointestinal tract.

Methods: The study was conducted on 286 fish bone ingestion patients who complained of dysphagia and irritation after eating fish. The patients were treated according to the hospital protocol regarding the removal of fish bone. The parameters for the analysis included the age and sex of the patients, location and characteristics of the foreign body, method of removal, and type of fish.

Results: The fish bone could be observed by the physical examination in the oral cavity and laryngopharynx in 198 patients (69.23%). For those patients in whom the foreign body could not be observed in oral cavity and laryngopharynx, noncontrast computed tomography (CT) (from nasopharynx to diaphragm) was performed. The fish bone was discovered in the esophagus of 66 patients (23.08%). The esophageal fish bone was successfully removed by transnasal flexible esophagoscopy (TNE) in 55 patients, the fish bone moved to the stomach in 10 patients and one fish bone was removed by rigid esophagoscopy due to esophageal abscess. The esophageal fish bone was mostly found in patients aged 50 years and older.

Conclusion: Fish bone foreign body ingestion in the esophagus appeared to be more common in older patients. Incorporating noncontrast CT and TNE can facilitate decision-making and adequate treatment for patients with fish bone impactions.

No MeSH data available.


Related in: MedlinePlus