• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.15.1-15
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• 1987

1980년 1월 1일부터 1986년 12월 31일까지 7년 동안 가톨릭의과대학부속 성모병원 이비인후과에 내원한 식도 및 기도이물환자 246명을 분석하여 다음과 같은 결론을 얻었다. 1) 식도 및 기도이물의 빈도는 4.5 : 1이었다. 2) 식도이물의 종류별 빈도는 주화가 55.2%로 가장 많았고 다음이 골편, 식품류 등의 순이었다. 기도이물에서는 콩류가 57.8%로 가장 많았고 첨단 철물류와 식품류는 다음으로 많았다. 3) 식도이물의 56.7%가 5세이하이었으며 주화 및 원반류는 5세 이하가 대부분이었다. 기도이물의 88.9%가 5세이하이었으며 콩류에서는 96.2%가 5세 이하이었다. 4) 식도이물은 남자가 58.7%로 여자보다 많았으며 기도이물은 남자가 82%로 여자보다 많았다. 5) 식도이물의 개재부위는 제 1협착부에 78.1%로 가장 많았으며 식품류는 제 2협착부에서 높은 빈도를 보였다. 기도이물에서는 기관지가 84.4%로 가장 많았고 좌우기관지별 이물의 비는 1 : 1로 같았다. 6) 이물의 개재기간은 식도이물이 1일 이내가 72.6%, 기도이물이 1일 이내가 17.8%이었다. 7) 기도이물의 흉부 X-선 소견은 폐쇄성 폐기종과 폐염이 각각 37.8%, 26.7%로 가장 많았다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.17.2-17
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• 1987

식도이물은 이비인후과 영역에서 흔히 경험할 수 있는 것으로 연령, 성별, 민족 등에 제한없이 발생할 수 있으며, 대부분의 경우 예기치 않게 돌발적이며 부주의로 인하여 발생되는 경우가 많다. 이물은 일상생활과 밀접한 관계가 있는 것으로서 그 종류가 매우 다양하다. 대부분의 식도이물의 경우, 진단 및 치료가 용이하나, 경우에 따라서는 이물의 종류, 개재부위, 체류기간, 선행질병 및 증상 등에 따라 진단 및 치료가 용이하지 않은 경우도 있다. 특히 다발성 식도협착이 있는 환자의 원위(distal) 협착부위에 개재한 식도이물은 식도경이 근위(proximal)협착부를 통과할 수 없으므로 이물제거가 상당히 힘들 경우가 많다. 저자들은 최근 부식성 식도염에 속발한 다발성 식도협착이 있는 2명의 환자에서 원위협착부위에 개재한 식도이물을 fluoroscopy 도움하에서 Medi-Tech biliary basket을 사용하여 제거하였기에 문헌적 고찰과 함께 보고하는 바이다.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.182-193
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• 1996

식도내 이물은 종종 어린이나 식도질환을 가진 환자, 죄수들, 정신박약자 및 정신질환자등의 위험성이 높은 성인에서 흔히 발생한다. 그러나 대부분의 이물은 저절로 위장관을 통과하나 날카롭고 뾰족하며 긴 이물은 위장관의 천공이나 혈관과 누공형성 및 다른 합병증을 초래할 수도 있다. 이물의 섭취는 대개 환자나 다른 목격자에 의하여 복용한 병력으로 진단할 수 있다. 그러나 어린이나 정신박약자는 병력을 얻을 수 없기 때문에 우선 의심하는 것이 중요한 진단방법이 될 수밖에 없다. 연하곤란과 연하통은 식도이물의 통상적인 증상이다. 주변기도의 압박으로 인한 호흡기 증상은 어린이에 흔하며 종종 성인에서도 관찰된다. 식도내 이물을 제거하는데 많이 사용되는 방법은 굴곡형내시경을 사용하여 제거하는 것이다. 이방법은 성인이나 어린이에서 전신마취없이 기존의 진정제 투여방법으로 시술할 수 있다. 이물제거에 사용되는 파지겸자와 올가미는 내시경이물제거술을 가능하게 하였고 굴곡형내시경에 사용되는 overtube는 기존의 강직 형내시경의 장점을 얻을 수 있어 뽀족하거나 날카로운 이물을 제거하는데 사용하게 되었다. 이런 내시경적이물제거 원칙을 잘 지키고 적절한 준비가 된다면 합병증이 거의 없이 98% 정도의 이물을 제거할 수 있다. 내시경을 사용하지 않는 여러 가지 방법은 천공의 위험성이 높고 흡인성폐렴을 유발할 수 있기 때문에 사용하지 않는 것이 낫다. 수술적인 처치는 천공이 되었거나 다른 이물로 인한 합병증이 있는 경우에만 드물게 적용된다.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.3.3-4
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• 1981

We have observed foreign body in food and air passage in 138 cases during the period from Jan. 1972 to Dec. 1980 in E.N.T. department of Kyung Hee university hospital. The following results were obtained. 1) Age distribution was predominent in under 5 years old showing 102 cases (73.9%). 2) Distribution of location was 132 cases in food passage and 6 cases in air passage. 3) In food passage, malewas 81 cases (61.4%). In air passage, male was 4 cases(66.7%). 4) Coin was the most frequent foreign body in food passage. Others were metals, meats, bony pieces, and shell. 5) Distribution of lodgement was frequent in first narrowing of esophagus. 6) Duration of lodgement was 112 cases (84.8%) within 24 hours in food passage and 4 cases (66.7%) within 24 hours in air passage.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.9.2-9
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• 1983

We have observed 74 cases of radiolucent foreign bodies in food and air passage in E. N. T. department of Hang Gang Sacred Hospital, from Jan. 1972 to Mar. 1983. The following results were obtained. 1) Distribution of location was 56 cases(75.6 %) in food passage and 18 cases (24.4 %) in air passage. 2) In age distribution, 46 cases (82.1 %) of F. B. in food passage were found in patient over 21 years old and 12 cases (66.7 %) of F. B. in air passage were found in patient under 5 years old. 3) Female seems to be more frequently involved than male in cases of F. B. of food passage and in cases of air passage, male is more frequent. Food passage male: female - - - 25 : 31 Air passage male: female - - - 10 : 8 4) Meats was the most frequent foreign body in food passage (19 cases-33.9%), and the bony pieces was next (17 cases-30.4 %). Plastic material was the most frequent foreign body in air passage (9 cases-49.9 %), and the vegetable seed was the second (4cases-22.0 %). 5) In the location of F. B. in food passage, the first narrowing of the esophagus was the most frequent site and in air passage, the bronchus-especially right bronchus-was the most frequent site. 6) In the duration of lodgement, 44 cases(78.6 %) of F.B. in food passage were visited with - in 24 hours, and 11 cases (61 %) of F. B. in air passage were visited with - in 24 hours. 7) Simple chest PA was checked in all patient and then, esophagogram was checked in 34 cases of F.B. in food passage, among them positive finding was noticed in 23 cases. 8) Removal of F. B. in food passage by esophagoscopy was performed in 54 cases (96.4 %), but in the cases of air passage, removal of F. B. by bronchoscopy was performed in 14 cases (77.8 %). 9) Complications of food passage by the F. B. itself or esophagoscopy were esophageal mucosal laceration (1 cases-1.8 %) and esophageal perforation (1 case -1. 8 %) and complication of air passage by F. B. itself or bronchoscopy were atelectasis (2 cases -11.1 %) and pneumonia (3 cases-16.7 %).

• Proceedings of the KOR-BRONCHOESO Conference
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• 1976.06a
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• pp.88.1-88
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• 1976

The authors have been performed a statistical survey for 228 cases with foreign bodies in the food and air passages who had visited the department of Otolaryngology, National Medical Center and removed endoscopically during the period of last 10 years from 1966 to 1975. The following results were obtained: 1. The total numbers of foreign bodies in the food and the air passages were 228 cases, and among of them 181 cases were foreign bodies in the food passage and 47 cases were foreign bodies in the air passage. The ratio between the food and the air passages was about 3.7 : 1. 2. The prevalent foreign bodies in the esophagus were coin, meat and food particles and bone in order of frequency. In air passage, bean and peanut were most prevalent foreign bodies and the next were metalic substances, fish bone in order of frequency. 3. In the age incidence, 65.4% of the esophageal foreign bodies and 67.6% of foreign bodies in the air passage were under 5 years of age especially coin, 92.9%. 4. In sex distribution, 99 cases were female, and the ratio between male and female was 1.3:1. There was no significant difference between male and female in the foreign bodies of the esophagus but the foreign bodies in the air passage were more prevalent in male as the ratio of 2.1:1. 5. The most prevalent site of lodgement in esophagus was first physiologic narrowing of the esophagus as the count of 83.8%. In foreign bodies of the air passage, bronchial foreign bodies were most frequent. And bronchial foreign bodies were more frequent in the right side as the ratio of 3.7:1. 6. In duration of lodgement, 56.0% of foreign bodies of the food passage were removed within 24 hours and almost of them were removed within 5 days. In foreign bodies in the air passage, only 32.4% were removed within 24 hours but 29.7% were removed within more than 1 week in the air passage. 7. Under the esophagoscope, granulation tissue were noted in the 5 cases of the foreign bodies in the esophagus due to foreign bodies. In foreign bodies of the air passage, complication were encountered in the 4 cases and also removed surgically and among of them, 2 patients were expired due to complications during post operative course.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.9.3-9
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• 1979

Foreign bodies in air and food passages are not uncommon problems in the otolaryngological fields and its etiological factors are closely related to the social environment and mode of life. It may complicate of esophageal perforation, periesphagitis, periesophageal abscess, mediastinitis, pneumothorax, pyothorax and lung abscess which may lead to the problems of life and death. The majority of esophageal foreign bodies which lodge in the esophagus can be removed endoscopically, but the following types of foreign bodies may require removal by the external route: 1. an impacted foreign body, 2. a foreign body producing periesophagitis after unsuccessful attempts at removal through the esophagoscope, and 3. a periesophageal abscess with a foreign body lodging in the abscess itself. Many interesting cases and statistical analysis of esophageal foreign bodies were reported by many authors, but only a few complicated cases were reported. Recently, we experienced 2 cases of esophageal foreign bodies which penetrate the cervical and thoracic esophageal wall and formed periesophageal abscess in 12 and 40 years-old males who swallowed of wire accidentally. The foreign bodies are successfully removed by the external routes through the lateral neck and chest. The postoperative courses were uneventful.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.8.4-8
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• 1981

Foreign bodies in the esophagus are frequently seen in the otolaryngologic field and there are numerous reports of them. Also the kinds of these foreign bodies are valiable and almost all things arround us are likely to be foreign bodies. Authors have recently experienced three cases of rare and interesting foreign bodies in the esophagus. Foreign bodies were removed by endoscopy and all of these were sharp square shaped hard plastic package which enclosing tablet of medicine. This is the report of clinical findings on these cases along with literature review.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.7.1-7
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• 1983

Esophageal perforation occurred rarely, but it leads to a high mortality and morbidity. Main cause of esophageal perforation in Korea is instrumental perforation in patients with lye stricture of esophagus during diagnostic endoscopy or therapeutic bouginage. A case of 25-year-old male patient entered to outpatient clinic. Chief complaints were mild pain at swallowing, mild fever elevation and chest tightness with radiating pain to shoulder and interscapular region for 1 day. On the X-ray film with barium soaked cotton piece in esophagus, it was revealed that foreign body (fish bone) had been located on the level of 2nd vertebra with leakage of barium to mediastinum. The foreign body was removed with endoscopy in Dept. of otolaryngology, and cervical mediastinostomy was performed in Dept. of thoracic surgery.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.9.2-9
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• 1977

A Statistical study was carried out on 64 cases of the foreign bodies in the food and air passages, who visited the Dept. of Otolaryng. of Korea General Hospital from Jan. 1971 to Dec. 1976. The following results were obtained. 1. The total number of foreign bodies were 64 cases, which is approximately 0.69% of the total number of new patients who visited the out patient department during the same period. Among them 55 cases were foreign bodies in the food passage and 9 cases were foreign bodies in the air passage. The ratio between the food and air passages was about 6.1 : 1. 2. The frequently encountered foreign bodies in the esophagus were coin, bone, meat and food particle in order. Bean and peanut were male and 31 case the most frequent foreign bodies in the air passage. 3. In sex distribution, 33 cases were male and 31 cases were female, and the ratio between male was 1.1:1. 4. In the age distribution, 35 cases (54.7%) of all foreign bodies were under 5-year-old, especially coin was 96.2%. 5. The most prevalent site of lodgement in the food passage was the 1st esophageal narrowing, which corresponds to 69.1%. 6. In duration of lodgement, 38 cases (69.1%) of foreign bodies in the food passage were removed within 24 hours, and the longest duration was 90 days. 7. Almost all of the foreign bodies in the food and air passages were removed under local or no anesthesia by esophagoscopy, laryngoscopy.