Endoscopic Treatment of Esophageal Foreign Bodies in the Elderly

Background: Ingestion of a foreign body is a prevalent condition among children and psychiatric patients; however, such an issue has seldom been discussed in the elderly. Methods: A retrospective review of medical records of patients more than 60 years of age with a diagnosis of esophageal foreign body (EFB) from December 2007 to December 2010 was performed. A total of 45 elderly patients (24 men and 21 women) were analyzed. Demographic data, impaction level of esophagus, types of EFB, underlying diseases, duration from ingestion to endoscopic intervention, endoscopic managements, and outcomes were analyzed. Results: The average age of these patients was 75.0 years (60-95 years). Among the materials that caused esophageal impaction, the most frequent were bones of animal origin (17/45 = 37.8%), followed by meat or food bolus (16/45 = 35.6%), dental prostheses (8/45 = 17.8%), and medicine packing (4/45 = 8.8%). In about half of these patients, the EFBs were entrapped in the cervical esophagus. There was no mortality. The success of removing EFB at an initial stage in these patients was about 88.8% (40/45). The retrieval-associated complications occurred in six patients with mis-swallowing of fish bones and medicine packing; four had wound bleeding, which need endoscopic hemostasis, and the other two had penetrating wounds that needed surgical repair. Conclusion: Flexible upper endoscopy is relatively safe and effective for extracting EFB in the elderly. Elderly patients with EFBs had a high rate of underlying diseases. Thus, additional care and considerations must be given to such population. Copyright (C) 2012, Taiwan Society of Geriatric Emergency 82 Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.