Üst Gastrointestinal Sistemde Yabancı Cisimlerin Değerlendirilmesi: Tanı ve Tedavi

Öz

Amaç: Araştırmada, yabancı cisim yutulması nedeniyle genel cerrahi kliniğinde acil endoskopi işlemi uygulanan ve endoskopi işleminin yetersiz kaldığı durumlarda cerrahi yöntem ile tedavi edilen vakaların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Tanımlayıcı nitelikte yapılan araştırmanın verileri yabancı cisim yutan hastaların dosyalarından elde edilmiştir. 2017-2020 yılları arasında 21 yabancı cisim yutma vaka dosyaları taranmıştır. Araştırmanın verileri SPSS paket programında analiz edildi. Analizlerde frekanslar, yüzde ve ortalama, ortanca kullanıldı. Bulgular: Yabancı cisim yutanların yarıdan fazlası (%52.3) erkektir. Yabancı cisimlerin %57.1 organik olup, en fazla en fazla üst özofagusta yerleşmiştir (%47.6). En sık görülen semptom disfaji (%38.1), %57.1’i ayaktan tedavi edilerek yatışa gerek duyulmamıştır. Komplikasyon oranı %14.3’tür. Vakaların %90.5’i endoskopi ile tanı konularak tedavi edilmiştir. Sonuç: Yabancı cisimlerin gerek tanı ve gerekse tedavisinde en önemli yöntem endoskopik işlemdir. Endoskopinin yetersiz olduğu sınırlı sayıda vakada ise cerrahi gerekmektedir.

Anahtar Kelimeler

• Yabancı Cisim
• Endoskopi
• Gastrointestinal
• Özefagus

Evaluation of Foreign Bodies in the upper Gastrointestinal System: Diagnosis and Treatment

Öz

Objective: The aim of this study was to evaluate the cases treated surgically in cases where emergency endoscopy was performed in the general surgery clinic due to foreign body ingestion and the endoscopy procedure was insufficient. Methods: The data of the descriptive study were obtained from the files of patients who ingested foreign bodies. Between 2017-2020, 21 foreign body ingestion case files were scanned. The data of the research were analyzed in the SPSS package program. Frequencies, percentage and mean, median were used in the analyzes. Results: More than half (52.3%) of those who ingested foreign bodies were men. 57.1% of foreign bodies are organic and mostly localized in the upper esophagus (47.6%). The most common symptom is dysphagia (38.1%), 57.1% was treated on an outpatient basis and hospitalization was not required. Complication rate is 14.3%. 90.5% of the cases were diagnosed and treated by endoscopy.Conclusion:The most important method in both diagnosis and treatment of foreign bodies is endoscopic procedure. Surgery is required in a limited number of cases where endoscopy is insufficient.

Anahtar Kelimeler

• Foreign Body
• Endoscopy
• Gastrointestinal
• Esophagus

Kaynakça

1. Yenidoğan E, Okan İ, Kayaoğlu H, Özsoy Z, Tali S, Şahin M. Özofagusa Takılan Yiyeceklerin Endoskopik Olarak Çıkarılması. Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dergisi 2014;6 (2):119-128.
2. Weissberg D, Refaely Y. Foreign bodies in the esophagus. Ann Thorac Surg. 2007;84(6):1854-7. https://doi.org/10.1016/j.athoracsur.2007.07.020.
3. Kay M, Wyllie R. Pediatric foreign bodies and their management. Curr Gastroenterol Rep. 2005;7(3):212-8. https://doi.org/10.1007/s11894-005-0037-6.
4. Thomas W. Sadler Langman’s Medical Embryology Lippincott Williams & Wilkins. 2006;10: 112.
5. Smith MT, Wong RK. Esophageal foreign bodies: types and techniques for removal. Curr Treat Options Gastroenterol 2006;9:75-84.
6. Athanassiadi K, Gerazounis M, Metaxas E, Kalantzi N. Management of esophageal foreign bodies: a retrospective review of 400 cases. Eur J Cardiothorac Surg. 2002;21(4):653-6. https://doi.org/10.1016/S1010-7940(02)00032-5.
7. Khurshid Z, Abdelbasit Elsayed Ali AE, Al Hamidi SAA. et al. Foreign Body Ingestion in Children: A Hospital Based Experience in Riyadh. Acta Scientific Paediatrics :2:10 (2019): 13-19.
8. Chaudhari SKS, Chaudhary SM. Endoscopic management of foreign bodies in the upper gastrointestinal tract. isj. 2020;7;7:2226-30. https:// doi.org/10.18203/2349-2902.

9. Ruan WS, Li YN, Feng MX, Lu YQ. Retrospective observational analysis of esophageal foreign bodies: a novel characterization based on shape. Scientific Reports. 2020; 10: 4273. https:// doi.org/10.1038/s41598-020-61207-8.
10. Yalçınkaya İ, Er M. Trakeobronş ve özofagus yabancı cisimlerinin tanı, tedavi ve komplikasyonları. Van Tıp Dergisi 1998;5:31-4.
11. Kefeli A, Başyiğit S, Yeniova A, Nazlıgül Y, Küçükazman M, Aktaş B. Üst gastrointestinal sistem yabancı cisimleri. Dicle Tıp Dergisi 2014;41(1):195-198. https://doi.org/10.5798/diclemedj.0921.2014.01.0398.
12. Çobanoğlu U, Yalçınkaya İ. Özofagus yabancı cisimleri: 175 olgunun analizi. Turkish J Thorac Cardiovasc Surg 2008; 16(4): 244-249.
13. Al-Qudah A, Daradkeh S, Abu-Khalaf M. Esophageal foreign bodies. Eur J Cardiothorac Surg. 1998;13(5):494-8. https://doi.org/10.1016/s1010-7940(98)00068-2.
14. Soprano JV, Mandl KD. Four strategies for the management of esophageal coins in children. Pediatrics. 2000;105(1):5. https://doi.org/10.1542/peds.105.1.e5.
15. Celik S, Aydemir B, Tanrıkulu H, Okay T, Doğusoy I. Esophageal foreign bodies in children and adults: 20 years experience. Ulus Travma Acil Cerrahi Derg 2013;19(3):229-34. https://doi.org/10.5505/tjtes.2013.22687.
16. Zhang S, Cui Y, Gong X, Gu F, Chen M, Zhong B. Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract in South China: A Retrospective Study of 561 Cases. Dig Dis Sci 2010;55(5):1305-12. https://doi.org/10.1007/s10620-009-0900-7.
17. Goh BK, Chow PK, Quah HM, Ong HS, Eu KW, Ooi LL, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg 2006;30(3):372-7. https://doi.org/10.1007/s00268-005-0490-2.
18. Ashraf O. Foreign body in the esophagus: a review. Sao Paulo Med J 2006;124(6):346-9. https://doi.org/10.1590/s1516-31802006000600010.
19. Akkuzu MZ, Sezgin O, Yaraş S, Özdoğan O, Üçbilek E, Ateş F, et al. Foreign Bodies on the Path of Nutrition: Retrospective Evaluation of Our Clinical Experience. Med Bull Haseki. 2020;58:15-20. https://doi.org/10.4274/haseki.galenos.2019.5263.
20. J Völker, C Völker, P Schendzielorz, Schraven SP, Radeloff A , Mlynski R, et al. Pathophysiology of esophageal impairment due to button battery ingestion. Int J Pediatr Otorhinolaryngol. 2017;100:77-85. https://doi.org/10.1016/j.ijporl.2017.06.030.
21. Apilioğulları B, Ceran S.Foreign Bodies in the Esophagus: 117 Cases. Kocaeli Med J. 2021;10(1): 106-111.
22. Kim JK, Kim SS, Kim JI, Kim SW, Yang YS, Choet SH, et al. Management of foreign bodies in the gastrointestinal tract: an analysis of 104 cases in children. Endoscopy 1999;31:302-304. https://doi.org/10.1055/s-1999-13.
23. Katsinelos P, Kountouras J, Paroutoglou G, Zavos C, Mimidis K, Chatzimavroudis G. Endoscopic techniques and management of foreign body ingestion and food bolus impaction in the upper gastrointestinal tract: a retrospective analysis of 139 cases. J Clin Gastroenterol 2006;40(9):784-9. https://doi.org/10.1097/01.mcg.0000225602.25858.2c.
24. Craig RM, Vanagunas AD. Foreign bodies in the eosophagus. In: Shields TW, editor. General thoracic surgery. Philadelphia: Lippincott Williams & Wilkins 2000. p. 1763-7.
25. Ko HH, Enns R. Review of foodbolus management. Can J Gastroenterol 2008;22(10):805–8. https://doi.org/10.1155/2008/682082.
26. Higo R, Matsumoto Y, Ichimura K, Kaga K. Foreign bodies in the aerodigestive tract in pediatric patients. Auris Nasus Larynx 2003;30(4):397-401. https://doi.org/10.1016/s0385-8146(03)00087-7.
27. Loh KS, Tan LK, Smith JD, Yeoh KH, Dong F. Complications of foreign bodies in the esophagus. Otolaryngol Head Neck Surg 2000;123(5):613-6. https://doi.org/10.1067/mhn.2000.110616.