关键词: 食管异物, 枣核, 并发症, 危险因素, 食管穿孔

Abstract: Objective  To analyze the clinical characteristics of esophageal foreign body impaction by gastroscopy intervention in adults. Methods  A retrospective analysis was conducted on 470 patients who underwent gastroscopic intervention for esophageal foreign bodies at the Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, from January 2019 to January 2024. The patients' gender, age, underlying esophageal conditions, date of endoscopic examination, type of anesthesia, the type, size, and shape of the foreign bodies, as well as the severity of complications were compared and analyzed in this study. Results  The median age of the patients was 62.5, with an equal male-to-female ratio of 1∶1. Totally 63.40% endoscopic examination were performed on weekdays. Local pharyngeal anesthesia was used in 96.17% of patients. The upper esophagus was the most common site of impaction (61.7%). Esophageal strictures were detected in 19.36% of patients during endoscopy. The size of the foreign bodies ranged from 0.4 cm to 13 cm, with an average of （2.44±1.03）cm. The most common foreign bodies were animal bones such as fish, chicken, and duck bones (47.02%), followed by jujube pits (19.36%). Female patients were significantly more likely to have jujube pit impactions (P<0.001). Two pressure points were identified in 28.94% of the foreign bodies. Mild complications related to foreign body impaction occurred in 416 cases (88.51%), while severe complications occurred in 54 cases (11.49%). Among those with severe complications, a higher proportion were elderly (P=0.009), female (P=0.045), had foreign bodies larger than 2.0 cm (P<0.05), jujube pits and had foreign bodies with two pressure points (P<0.001). Swallowing jujube pits and having foreign bodies larger than 3.0 cm were independent risk factors for severe complications. Conclusion  Elderly patients, female patients, foreign bodies larger than 2.0 cm, foreign bodies with two pressure points, and jujube pits are more likely to develop severe esophageal complications. Early endoscopic intervention is recommended for patients with these characteristics.

Key words: esophageal foreign body, jujube pit, complications, risk factors, esophageal perforation