Analysis of Risk Factors of Esophageal Perforation in Patients with Esophageal Foreign Bodies

Abstract

Background/Aims: Most gastrointestinal foreign bodies pass spontaneously without sequelae or complications. However, if esophageal foreign bodies are left untreated, the risk of perforation markedly elevates. Esophageal perforation can result in mediastinitis, lung abscess, pneumothorax, pericarditis and cardiac tamponade, being associated with high morbidity and mortality. The aims of this study were to characterize clinical features and to evaluate the risk factors associated with perforation induced by esophageal foreign bodies. Methods: We analyzed medical records of 295 cases of foreign bodies in the esophagus at Ajou University Hospital between January 1997 and July 2008. Among them, seven patients (2.3%) experienced esophageal perforation. We compared the clinical aspects of perforation and non-perforation groups such as foreign body type, size, its location, and impaction duration including demographic features of patients. Results: Esophageal perforation was frequent in patients over 40 years of age with sharp foreign bodies in the upper esophagus with long impaction time. Age group (over 40), foreign body shape and location have no statistical significance. However, impaction duration more than 24 hours (p<0.01) and complaining of chest pain (p<0.05) were significantly associated with esophageal perforation induced by esophageal foreign bodies. Conclusions: Esophageal perforation occurred in 2.3% of patients with esophageal foreign bodies. When patients with esophageal foreign bodies complain of chest pain or its impaction duration is more than 24 hours, the risk of esophageal perforation increases, therefore clinicians should raise awareness.