Clinical Analysis Of Complications Of Esophageal Foreign Bodies

Objective: To explore and analyze the clinical characteristics and prevention measures of complications of esophageal foreign body.Methods: The study is a retrospective analysis conducted in otolaryngology of The second affiliated hospital of fujian medical university from January,2014 to October,2019.We chose 383 qualified patients presenting with esophageal foreign bodies(FBs)and divided them into 2 groups by with or without complications,Including esophageal perforation,Traumatic esophagitis,neck abscess,caustic injuries of esophagus,Periesophageal abscess,periesophagitis,mediastinal emphysema,Subcutaneous emphysema,Mediastinal inflammatory,Mediastinal abscess,Pharyngeal abscess,tracheoesophageal fistula.The confirmation of complications is mainly based on clinical symptoms,signs,imaging examination and endoscopic examination results.Data collected included age,gender,location of foreign body incarceration,time of foreign body incarceration,Whether to swallow forcibly after foreign body incarceration,foreign body characteristics or shape,treatment methods and Symptoms and signs of complications.Then we form logistic regression mode to conduct univariate logistic analysis and test the significance.Furthermore,we form logistic regression mode to conduct multivariate logistic analysis and demonstrate the effect of risk factors on complications.of esophageal foreign bodies.Results: 1.There were 73(19.06%)patients coming up with complications among 383 qualified patients,including 29 cases of esophageal perforation(The incidence of7.57%),23 cases of Traumatic esophagitis(6.01%),5 cases of neck abscess(1.31%),including 4 cases of caustic injuries of esophagus(1.04%),3 cases of Periesophageal abscess(0.78%),2 cases of periesophagitis(0.52%),2 cases of mediastinal emphysema(0.52%),1 case of Subcutaneous emphysema,Mediastinitis,Mediastinal abscess,Pharyngeal abscess,tracheoesophageal fistula respectiveil(0.26%).Suggesting that esophageal perforation is the most common complication.2.There were 175 male patients(45.69%),Complications occurred in 31 cases(17.71%);208 female patients(54.31%),Complications occurred in 42 cases(20.19%);The results showed that gender was not a risk factor for esophageal foreign body complications.3.There were306 cases(79.90%)of sharp foreign body incarceration and 69 cases(22.55%)of complications.The results showed that The probability of incarceration of sharp foreign body is the highest,and the probability of complications of special foreign body is the highest.4.There were 92 patients(24.02%)more than 60 years old group,and 29patients(31.52%)had complications.suggestting that the proportion of esophageal foreign bodies and complications was the highest more than 60 age group.5.There were157 patients(40.99%)in the force-swallowing group,51 patients(32.48%)had complications.There were 226 patients(59.01%)in the no force-swallowing group,22patients(9.73%)had complications.suggestting that forced swallowing after incarcerated foreign body increases the incidence of complications of esophageal foreign body.6.There were 257 cases(67.10%)of foreign body incarceration in the esophageal neck group,and 43 cases(16.73%)of complications.Foreign bodies were embedded in the lower thoracic segment of the esophagus in 9 cases(2.35%)and complications in 7 cases(77.78%).Suggestting that the incidence of foreign body incarceration in the esophageal cervical segment was the highest,the incidence of esophageal foreign body in the lower thoracic segment was the lowest,but the incidence of complications was the highest.7.There were 51 cases(13.32%)in the group with foreign bodies incarcerated for more than 48 hours,and 21 cases(incidence rate 41.18%)with complications.suggestting that more than 48 hours of foreign body incarceration resulted in an increased incidence of complications of esophageal foreign body.8.Single factor logistic regression analysis showed that foreign body character(P<0.05),patient age(P<0.05),Whether to swallow forcibly after foreign body incarceration(P<0.05),foreign body incarceration location(P<0.05),foreign body incarceration time(P<0.05)were risk factors for esophageal foreign body complications.9.Multi-factor regression model analysis showed that foreign body character(OR=4.667),foreign body incarceration location(OR=1.511)and foreign body incarceration time(OR=2.780)were independent risk factors for esophageal foreign body complications(P<0.05).Conclusions: 1.The age,incarceration time,foreign body characteristics,incarceration location,forced swallowing of the patients were risk factors for complications of esophageal foreign body.2.The incidence of foreign body in the esophageal cervical segment was the highest,the incidence of foreign body in the lower thoracic segment of the esophagus was the lowest,but the incidence of complications was the highest.3.Esophageal foreign bodies should be removed as soon as possible to avoid serious complications.