A T Y Lai1, T L Chow, D T Y Lee, S P Y Kwok. 1. Department of Surgery, United Christian Hospital, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong, China. alexlai1996@sinaman.com
Abstract
BACKGROUND: The aim of this study was to determine the predictive risk factors for complications resulting from foreign body ingestion. METHODS: A consecutive series of 1338 patients with suspected foreign body ingestion presenting from 1996 to 2000 were studied retrospectively. The potential risk factors for complications after foreign body ingestion were analysed by multivariate logistic regression and included concurrent medical illness, age, duration and types of symptoms, types of foreign body ingested, positive cervical radiographic findings and the level of foreign body impaction. RESULTS: Fish bone (62.7 per cent) was the commonest type of foreign body ingested. Most of the objects were impacted at or above the cricopharyngeus, the commonest site being the valleculae (31.4 per cent). Multivariate analysis showed that presentation delayed for more than 2 days (P < 0.001), positive cervical radiographic findings (P < 0.001) and foreign body impacted at the cricopharyngeus (P = 0.009) or upper oesophagus (P = 0.005) were significant independent risk factors associated with the development of complications after foreign body ingestion. CONCLUSION: In patients with a foreign body seen on plain cervical radiography, presentation delayed for more than 2 days after ingestion, and foreign body impacted at the level of the cricopharyngeus or oesophagus there is a high degree of correlation with the occurrence of complications. Awareness should be raised when these risk factors are present. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
BACKGROUND: The aim of this study was to determine the predictive risk factors for complications resulting from foreign body ingestion. METHODS: A consecutive series of 1338 patients with suspected foreign body ingestion presenting from 1996 to 2000 were studied retrospectively. The potential risk factors for complications after foreign body ingestion were analysed by multivariate logistic regression and included concurrent medical illness, age, duration and types of symptoms, types of foreign body ingested, positive cervical radiographic findings and the level of foreign body impaction. RESULTS: Fish bone (62.7 per cent) was the commonest type of foreign body ingested. Most of the objects were impacted at or above the cricopharyngeus, the commonest site being the valleculae (31.4 per cent). Multivariate analysis showed that presentation delayed for more than 2 days (P < 0.001), positive cervical radiographic findings (P < 0.001) and foreign body impacted at the cricopharyngeus (P = 0.009) or upper oesophagus (P = 0.005) were significant independent risk factors associated with the development of complications after foreign body ingestion. CONCLUSION: In patients with a foreign body seen on plain cervical radiography, presentation delayed for more than 2 days after ingestion, and foreign body impacted at the level of the cricopharyngeus or oesophagus there is a high degree of correlation with the occurrence of complications. Awareness should be raised when these risk factors are present. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.