七年制医学课件 耳鼻喉 7食管异物

Foreign Body in the Esophagus 食 管 异 物 重庆医科大学附属第一医院耳鼻喉科重庆医科大学附属第一医院耳鼻喉科 陈陈 鸿鸿 雁雁 1、Anatomy 4 physiological narrows (4个生理性狭窄) The entrance of the esophagus（食道入口） About the lever of 4th thoratic vertebra (第4胸椎) About the lever of 5th thoratic vertebra (第5胸椎) About the lever of 10th thoratic vertebra (第10胸椎) 2、Etiology(病因学) (1) Common in children and the elders（老人和 儿童常见） (2) Diseases of the esophogus itself（食道本身病变 ） (3) Foreign body mostly located in the first narrow（第一狭窄常见） (4) Animal foreign bodies are often found（动物 性异物常见） Entrance of esophagus（食道入口） 3、Clinical Appearance（临床表现） (1) Dysphagia (吞咽困难) (2) Dynphagia or odynophagia(吞咽疼痛) (3) Symptoms of respiratory system (呼吸道症状 ) Dyspnea (呼吸困难) Apnea（窒息） (4) limitted activity of the neck 颈部活动受限 (5) high fever 发热 (6) inflammation of esophagus 食道穿破感染 4、Diagnosis(诊断) (1) The history of swallow sth. (误吞异物史) (2) Clinical symptoms(临床症状) (3) PE （physical examination）（体格检查） (4) X-ray: A、Metallic foreign bodies（金属异物）- easily B、fish bone. meat (duck chicken) bone（ 动物骨肉）-difficult a wisp of barium cotton may be helpful （钡棉透视） (5) Esophagoscopy（食管镜检查） lTo examine the esophagus lTo take out the foreign bodies The upper rim of the coin is just visible in the postcricoid region Foreign body, toy key, in cervical esophagus Foreign body, cervical esophagus 5、Complication（并发症） (1) Perforation or inflamation of the esophagus (食管穿孔或食道炎症) (2) Aerodermectasia or Pneumohypoderma （皮下气肿） (3) Periesophagitis or mediastinitis (食管周围炎或纵隔炎) (4) Breaking-out of great blood vessel (血管破溃) (5) Tracheo-esophageal fistula (气管食管瘘) 6、Treatment (治疗) （1）Removal of the foreign body （异物取出术） usually rigid esophagoscopy