七年制医学课件耳鼻喉7食管异物

ForeignBodyintheEsophagus食管异物

重庆医科大学附属第一医院耳鼻喉科陈鸿雁

1、Anatomy4physiologicalnarrows(4个生理性狭窄)Theentranceoftheesophagus（食道入口）Abouttheleverof4ththoraticvertebra(第4胸椎)Abouttheleverof5ththoraticvertebra

(第5胸椎)Abouttheleverof10ththoraticvertebra

(第10胸椎)2、Etiology(病因学)(1)Commoninchildrenandtheelders（老人和儿童常见）(2)Diseasesoftheesophogusitself（食道本身病变）(3)Foreignbodymostlylocatedinthefirstnarrow（第一狭窄常见）(4)Animalforeignbodiesareoftenfound（动物性异物常见）Entranceofesophagus（食道入口）3、ClinicalAppearance（临床表现）(1)

Dysphagia(吞咽困难)(2)

Dynphagiaorodynophagia(吞咽疼痛)(3)

Symptomsofrespiratorysystem

(呼吸道症状)Dyspnea(呼吸困难)Apnea（窒息）

(4)limittedactivityoftheneck

颈部活动受限(5)highfever

发热

(6)inflammationofesophagus

食道穿破感染4、Diagnosis(诊断)(1)Thehistoryofswallowsth.(误吞异物史)(2)Clinicalsymptoms(临床症状)(3)PE（physicalexamination）（体格检查）(4)X-ray:A、Metallicforeignbodies（金属异物）-----easilyB、fishbone.meat(duckchicken)bone（动物骨肉）-------difficultawispofbariumcottonmaybehelpful（钡棉透视）(5)Esophagoscopy（食管镜检查）

ToexaminetheesophagusTotakeouttheforeignbodies

TheupperrimofthecoinisjustvisibleinthepostcricoidregionForeignbody,toykey,incervicalesophagusForeignbody,cervicalesophagus5、Complication（并发症）(1)Perforationorinflamationoftheesophagus(食管穿孔或食道炎症)(2)AerodermectasiaorPneumohypoderma

（皮下气肿）(3)Periesophagitisormediastinitis

(食管周围炎或纵隔炎)(4)Breaking-outofgreatbloodvessel

(血管破溃)(5)Tracheo-esophagealfistula

(气管食管瘘)6、Treatment(治疗)（1）Removaloftheforeignbody（异物取出术）usuallyrigidesophagoscopy（通常用硬管）