Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency

• Published in: Journal of the Formosan Medical Association 2016-08, Vol.115 (8), p.639-644
• Main Authors: Tseng, Chia-Chen, Hsiao, Tzu-Yu, Hsu, Wei-Chung
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Deglutition Disorders - etiology; Endoscopy - instrumentation; Endoscopy - methods; esophageal foreign body; Esophagus - diagnostic imaging; Female; flexible endoscopy; Foreign Bodies - diagnostic imaging; Foreign Bodies - therapy; Humans; Infant; Internal Medicine; Length of Stay; Male; Middle Aged; Radiography; Retrospective Studies; rigid endoscopy; Taiwan; Tertiary Care Centers; Time Factors; Young Adult
• ISSN: 0929-6646
• DOI: 10.1016/j.jfma.2015.05.016

Background/Purpose Despite the effectiveness of endoscopies in removing ingested foreign bodies (FBs) impacted in the esophagus, the merits and limitations of flexible endoscopy (FE) and rigid endoscopy (RE) remain unclear. Therefore, this study compares the advantages and disadvantages of both endoscopic procedures from a clinical perspective. Methods A retrospective review was made of 273 patients suspected of esophageal FBs in emergency consultations of a tertiary medical referral center from March 2010 to March 2014. All patients received routine physical examinations, otolaryngological examinations, and X-rays of the neck and chest. The door-to-endoscopy time, procedure time, postendoscopic hospital stay, successful removal rates, and complications were analyzed as well. Results In this study, the most common esophageal FBs were fish and animal bones (76%) in adults and coins (74%) in children. The patients with existing esophageal FBs had significantly more frequent symptoms of dysphagia and signs of linear opacity as detected with lateral neck radiography than those without FB. Additionally, the door-to-endoscopy time, procedure time, and postendoscopic hospital stay was significantly shorter in FE patients than in RE patients. However, both RE and FE patients had high rates of successful FB removal (95%) and low complication rates (2%). Conclusion Both FE and RE remove esophageal FBs successfully, as evidenced by their high success rates, low complication rates, and high detection rates. Although FE under local anesthesia is a less time-consuming procedure for adults, RE under general anesthesia may be preferable for children and can serve as an alternative to FE.