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Vol. 64. Issue 3.
Pages 197-203 (May - June 2013)
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Vol. 64. Issue 3.
Pages 197-203 (May - June 2013)
Original Article
The Management of Ingested Foreign Bodies in an Ear, Nose, and Throat Emergency Unit: Prospective Study of 204 Cases
Tratamiento de la ingestión de cuerpos extraños en una unidad de urgencias de otorrinolaringología: estudio prospectivo de 204 casos
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Nuno Marçala,??
Corresponding author
nunomarcal.orl@gmail.com

Corresponding author.
, João-Bruno Soaresb, Gabriel Pereiraa, Joana Guimarãesa, Matos Gonçalvesa, Tiago Godinhoa
a Department of Otorhinolaryngology, Hospital of Braga, Braga, Portugal
b Department of Gastroenterology, Hospital of Braga, Braga, Portugal
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Figures (2)
Tables (3)
Table 1. Characterization of Patients Included in the Study (n=204).
Table 2. Predictive Variables for Retrieval of Foreign Body by ENT in Univariate and Multivariate Analyses and Their Diagnostic Properties.
Table 3. Rate of Retrieval of FB by ENT and ENT+Gastro Regarding the Type of FB, Duration of Symptoms, and Location of Symptoms.
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Abstract
Aims

To determine how often ingested foreign bodies are found and what parameters may predict their retrieval.

Methods

During 1 year, we prospectively studied all patients referred to our Ear, Nose, and Throat Emergency Unit because of foreign body ingestion.

Results

During the study, 204 (median age – 42 years [10 months–84 years]) patients were admitted because of ingested foreign body. The most common was fish bone (88%). Most patients were admitted <24-h after ingestion (72%) and complained of symptoms above the cricoid cartilage (79%). A foreign body was removed by Ear, Nose, and Throat team in 108 (53%) patients. Twenty-three (11%) patients were referred to Gastroenterology. In 9 (39%) of these patients, a foreign body was identified by esophagogastroscopy, always from the esophagus. Predictive variables for retrieval of foreign body by Ear, Nose, and Throat team were ingested fish bone (P=.000; odds ratio [OR]=17.3), short duration (<6h) of symptoms (P=.001; OR=2.3) and symptoms above or at the level of cricoid cartilage (P=.000; OR=8.9). In patients with symptoms below the cricoid cartilage the rate of retrieval of foreign body by Ear, Nose, and Throat team (11%) was significantly increased by Gastroenterology (41%; P=.03).

Conclusions

Patients with ingestion of foreign body who ingest fish bone present within the first 6h or complain of symptoms at or above cricoid cartilage and deserve greater investment in terms of time and resources for retrieval of ingested foreign body by Ear, Nose, and Throat team.

Keywords:
Foreign bodies
Ear, Nose, and Throat Emergency Unit
Morbidity
Management
Retrieval
Resumen
Objetivos

Determinar la frecuencia con la que se encuentran cuerpos extraños ingeridos y los factores que pueden predecir su extracción.

Métodos

Durante un año estudiamos prospectivamente a todos los pacientes que fueron remitidos a nuestro servicio de Urgencias Otorrinolaringológicas por la ingestión de cuerpos extraños.

Resultados

Durante el estudio admitimos a 204 pacientes (edad media: 42 años [10 meses-84 años]) a causa de la ingestión de cuerpos extraños. El más frecuente fue la espina de pescado (88%). La mayoría de estos pacientes acudieron en las primeras 24h posteriores a la ingestión (72%), y referían síntomas por encima del cartílago cricoides (79%). El cuerpo extraño fue identificado y extraído por ORL en 108 pacientes (53%). Veintitrés pacientes (11%) fueron remitidos a Gastroenterología. En 9 de estos pacientes (39%), el cuerpo extraño fue identificado mediante endoscopia digestiva alta, siempre en el esófago. Las variables predictivas para la extracción por el equipo de ORL fueron la ingesta de espina de pescado (p=0,000; odds ratio [OR]=17,3), la corta duración de los síntomas (<6h) (p=0,001; OR=2,3) y los síntomas por encima o a la altura del cartílago cricoides (p=0,000; OR=8,9). En los pacientes con síntomas por debajo del cartílago cricoides la tasa de retirada del cuerpo extraño por el equipo de ORL (11%) fue significativamente superada por Gastroenterología (41%; p=0,03).

Conclusiones

Los pacientes con ingestión de cuerpo extraño, que han ingerido espinas de pescado, y que acuden durante las primeras 6h, o se quejan de síntomas a la altura o por encima del cartílago cricoide, justifican una mayor inversión de tiempo y recursos en cuanto a la extracción de cuerpos extraños ingeridos por el ORL.

Palabras clave:
Cuerpos extraños
Unidad de Urgencias de Otorrinolaringología
Morbilidad
Tratamiento
Retirada

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