Detection of foreign bodies in the digestive tract, using rigid esophagoscopy and the plain film soft tissue neck x-ray
Abstract
A retrospective study was undertaken of 137 patients diagnosed with or suspected of having foreign bodies in the digestive tract, and undergoing rigid endoscopy in Songklanagarind Hospital from January 1, 1994 to December 31, 2001. A history of foreign body ingestion and odynophagia or dysphagia was usually described by the patients. Only 10 patients were found to have a foreign body during the physical examination, but 91 of the 127 remaining suspected of having a foreign body were so confirmed after rigid endoscopy under general anesthesia was performed. The cricopharyngeus sphincter was the most common site of impaction (66%). Fish bones were the most common foreign body (46.1%), and were also associated with 27 of 36 patients with negative esophagoscopy. There was no difference in clinical characteristics or physical examination of the patients who had no foreign body at esophagoscopy compared with the patients in whom a foreign body was found. In this study a plain film soft tissue neck x-ray was conclusive in determining the presence of a metallic foreign body, and for fish or other bones the sensitivity was 78.9% and the specificity 75.9%.
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