Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China
Abstract Background Impaction of jujube pits in the upper gastrointestinal (GI) tract is a special clinical condition in the northern Chinese population. Endoscopic removal is the preferred therapy, but there is no consensus on the management strategies. We reported our individualized endoscopic str...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-020-01008-y |
| _version_ | 1819279006226186240 |
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| author | Ji-Tao Song Xiao-Hua Chang Shan-Shan Liu Jing Chen Ming-Na Liu Ji-Feng Wen Ying Hu Jun Xu |
| author_facet | Ji-Tao Song Xiao-Hua Chang Shan-Shan Liu Jing Chen Ming-Na Liu Ji-Feng Wen Ying Hu Jun Xu |
| author_sort | Ji-Tao Song |
| collection | DOAJ |
| description | Abstract Background Impaction of jujube pits in the upper gastrointestinal (GI) tract is a special clinical condition in the northern Chinese population. Endoscopic removal is the preferred therapy, but there is no consensus on the management strategies. We reported our individualized endoscopic strategies on the jujube pits impacted in the upper GI tract. Methods In this retrospective study, we included 191 patients (male: 57; female: 134) who presented to our hospital with ingestion of jujube pits between January 2015 and December 2017. Demographic information, times of hospital visiting, locations of jujube pits, endoscopic procedures, post-extraction endoscopic characteristics were analyzed. Management strategies including sufficient suction, repeated irrigation, jejunal nutrition and gastrointestinal decompression were given based on post-extraction endoscopic characteristics and impacted locations. Results Peak incidence was in the second quarter of each year (85/191 cases, 44.5%). Among the 191 cases, 169 (88.5%) showed pits impaction in the esophagus, 20 (10.5%) in the prepyloric region and 2 (1.0%) in the duodenal bulb. A total of 185 patients (96.9%) had pits removed with alligator jaw forceps, and 6 (3.1%) underwent suction removal with transparent caps placed over the end of the endoscope to prevent injury on removal of these pits with two sharp painted edges. Post-extraction endoscopic manifestations included mucosal erosion (26.7%), mucosa laceration (24.6%), ulceration with a white coating (18.9%) and penetrating trauma with pus cavity formation (29.8%). All patients received individualized endoscopic and subsequent management strategies and showed good outcomes. Conclusions Individualized endoscopic management for impacted jujube pits in the upper GI tract based on post-extraction endoscopic characteristics and impacted locations was safe, effective, and minimally invasive. |
| first_indexed | 2024-12-24T00:21:02Z |
| format | Article |
| id | doaj.art-7669fae7f5924df194d4d2b908e377a7 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-24T00:21:02Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-7669fae7f5924df194d4d2b908e377a72022-12-21T17:24:36ZengBMCBMC Surgery1471-24822021-01-012111710.1186/s12893-020-01008-yIndividualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern ChinaJi-Tao Song0Xiao-Hua Chang1Shan-Shan Liu2Jing Chen3Ming-Na Liu4Ji-Feng Wen5Ying Hu6Jun Xu7Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical UniversityDepartment of Gastroenterology and Hepatology, The First Hospital of HarbinDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical UniversityDepartment of Gastroenterology and Hepatology, The Second Affiliated Hospital of Harbin Medical UniversityAbstract Background Impaction of jujube pits in the upper gastrointestinal (GI) tract is a special clinical condition in the northern Chinese population. Endoscopic removal is the preferred therapy, but there is no consensus on the management strategies. We reported our individualized endoscopic strategies on the jujube pits impacted in the upper GI tract. Methods In this retrospective study, we included 191 patients (male: 57; female: 134) who presented to our hospital with ingestion of jujube pits between January 2015 and December 2017. Demographic information, times of hospital visiting, locations of jujube pits, endoscopic procedures, post-extraction endoscopic characteristics were analyzed. Management strategies including sufficient suction, repeated irrigation, jejunal nutrition and gastrointestinal decompression were given based on post-extraction endoscopic characteristics and impacted locations. Results Peak incidence was in the second quarter of each year (85/191 cases, 44.5%). Among the 191 cases, 169 (88.5%) showed pits impaction in the esophagus, 20 (10.5%) in the prepyloric region and 2 (1.0%) in the duodenal bulb. A total of 185 patients (96.9%) had pits removed with alligator jaw forceps, and 6 (3.1%) underwent suction removal with transparent caps placed over the end of the endoscope to prevent injury on removal of these pits with two sharp painted edges. Post-extraction endoscopic manifestations included mucosal erosion (26.7%), mucosa laceration (24.6%), ulceration with a white coating (18.9%) and penetrating trauma with pus cavity formation (29.8%). All patients received individualized endoscopic and subsequent management strategies and showed good outcomes. Conclusions Individualized endoscopic management for impacted jujube pits in the upper GI tract based on post-extraction endoscopic characteristics and impacted locations was safe, effective, and minimally invasive.https://doi.org/10.1186/s12893-020-01008-yEndoscopyForeign bodyJujube pitUpper gastrointestinal tract |
| spellingShingle | Ji-Tao Song Xiao-Hua Chang Shan-Shan Liu Jing Chen Ming-Na Liu Ji-Feng Wen Ying Hu Jun Xu Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China BMC Surgery Endoscopy Foreign body Jujube pit Upper gastrointestinal tract |
| title | Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China |
| title_full | Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China |
| title_fullStr | Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China |
| title_full_unstemmed | Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China |
| title_short | Individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract: a 3-year single-center experience in northern China |
| title_sort | individualized endoscopic management strategy for impacting jujube pits in the upper gastrointestinal tract a 3 year single center experience in northern china |
| topic | Endoscopy Foreign body Jujube pit Upper gastrointestinal tract |
| url | https://doi.org/10.1186/s12893-020-01008-y |
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