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Diagnosis and Endoscopic Management of Upper Gastrointestinal Foreign Bodies.
MedLine Citation:
PMID:  21804366     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION:: The objective is to evaluate the diagnosis of foreign body (FB) ingestion and report on the endoscopic management in Taiwan. METHODS:: This retrospective study enrolled 159 adult patients with confirmed diagnosis of upper gastrointestinal FBs who received endoscopic management in the emergency department. RESULTS:: The patients' mean age was 57.0 ± 19.2 years, and 66 (37.7%) of the patients were 65 years or older. Majority had a clear history and symptoms of FB ingestion. However, 9 (5.7%) initially ignored the accidental swallowing of FBs and were diagnosed late. The mean time spent for diagnosis was 1.8 days in those with uncertain history. Only 47.1% of those with radiographic studies had positive findings. Fish bones, press-through package and dentures were the most common culprits in this population of Asian elderly. Majority of FBs were located in the esophagus, especially in the upper third. Endoscopic FB extraction was successful in 96.9% of cases, while surgery was required in only 5 patients. The complication rate was 6.9%, including mucosal laceration (n = 10) and suspected perforation (n = 1), all of which were successfully managed conservatively. There was no death due to FB ingestion or endoscopy. CONCLUSIONS:: In FB ingestion, history usually points toward the diagnosis. Patients with an uncertain history are usually diagnosed late, and plain radiography cannot reliably predict the presence of FB. Endoscopic management is safe and effective for FBs.
Authors:
Yu-Hui Chiu; Sen-Kuang Hou; Sau-Chin Chen; Chorng-Kuang How; Carlos Lam; Wei-Fong Kao; David Hung-Tsang Yen; Mu-Shun Huang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-28
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  -     ISSN:  1538-2990     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-8-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Emergency Department (y-hc, c-kh, w-fk, dh-ty, m-sh) and Nursing Department (s-cc), Taipei Veterans General Hospital; Emergency Department (y-hc, cl), Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan; Emergency Department (s-kh), National Yang-Ming University Hospital, I-Lan, Taiwan; and Institute of Environmental and Occupational Health Sciences (y-hc, s-kh, w-fh) and Department of Emergency Medicine (c-kh, dh-ty, m-sh), National Yang-Ming University School of Medicine, Taipei, Taiwan.
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