Üst gastrointestinal sistem yabancı cisimleri ve gıda takılmalarında endoskopi deneyimimiz

Giriş ve Amaç: Yabancı cisimlerin yutulmasına bağlı başvurular, gastroenterolojik aciller arasında önemli bir yer tutmaktadır. Bu çalışmadaki amacımız; üst gastrointestinal sistemde yabancı cisim veya gıda takılması nedeniyle endoskopi yapılan hastalarımızı araştırmak ve klinik tecrübelerimizi paylaşmaktır. Gereç ve Yöntem: Hitit Üniversitesi Hastanesi acil servisine Mart 2017-Mart 2020 tarihleri arasında yabancı cisimlerin yutulmasına bağlı başvurarak endoskopi yapılan olgular çalışmaya dahil edildi. Bulgular: Çalışmaya toplam 31 hasta (13 kadın, 18 erkek) dahil edildi. Endoskopik tedavi başarı oranı %96.8 (n=30/31) idi. Hastaların acil servise müracaatındaki şikayetleri yabancı cismi hissetme %87.1 disfaji %74.2, odinofaji %22.6 iken %12.9 hasta asemptomatik idi. Yabancı cismin özelliği olarak hastaların %58.1 inde künt/yumuşak cisimler ve gıda impaksiyonu izlenirken; %41.9 hastada sivri/kesici/delici cisim mevcuttu. Yerleşim yeri hastaların %83.9’unda özofagus; %12.9’unda mide; %3.2’sinde duodenum idi. Acil servise başvurularında median zaman (acile giriş kayıt saati) 14:47 idi. Acile ilk başvurudan endoskopiye kadar geçen süre 1-24 saat arası, median süre ise 3 saat idi. Endoskopik tedavi yöntemleri olarak; biyopsi forsepsi, fare dişli/timsah dişli grasperlar, snare, fileli snare, overtüp ya da endoskop yardımıyla mideye ilerletme yöntemleri kullanıldı. Sonuç: Üst gastrointestinal sistem yabancı cisimlerinde endoskopik tedavi yöntemleri etkili ve güvenlidir. Endoskopik tedavide seçilecek yöntemler; yabancı cismin tipi, yabancı cismin yeri, eşlik eden diğer faktörlere ve hastanın özelliklerine göre bireyselleştirilmelidir.

Anahtar Kelimeler:

Yabancı cisim, endoskopi, gıda takılması, üst gastrointestinal sistem

Endoscopic management of foreign bodies and food impactions in the upper gastrointestinal tract

Background and aims: Foreign object ingestion and food bolus impaction have an important place among gastroenterological emergencies. Herein, clinical experiences of patients with foreign body ingestion in a tertiary referral center is reported. Materials and methods: Included in this study are patients at the Hitit University Hospital who underwent endoscopy with ingestion of foreign bodies or food impactions between March 2017 and 2020. Results: A total of 31 patients (13 females and 18 males) were enrolled. Success rate for endoscopic treatment was 96.8% (n=30/31). Patients presented feeling of foreign body 87.1%, dysphagia 74.2%, odynophagia 22.6%, whereas 12.9% were asymptomatic. Of the patients, 58.1% was observed to have blunt/soft foreign bodies and food impaction and 41.9% having sharp/cutting/piercing objects. Foreign bodies were found in the esophagus (83.9%), stomach (12.9%), and duodenum (3.2%). The median time for emergency service check-in was at 14:47. The time interval between emergency services to endoscopy (door-to-scope) was 1–24 hr (median of 3 hr). Endoscopic treatment methods were retrieval forceps, rat/alligator-tooth forceps, polypectomy snare, retrieval baskets, overtube, and pushing to the gastric cavity. Conclusions: For retrieval of foreign bodies, endoscopic treatment methods were safe and effective. Endoscopic methods should be individualized according to the foreign body’s type and location and the patient’s clinical characteristics.

Keywords:

Foreign body, endoscopy, food impaction, upper gastrointestinal tract,

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