Analysis of the management and risk factors for complications of esophageal foreign body impaction of jujube pits in adults

Introduction
Foreign body impaction is a common emergency in the field of otolaryngology. The prevalence of a jujube pit as an esophageal foreign body has increased in the Jiaodong Peninsula. However, reports on this are scarce.

Aim
To investigate the methods for diagnosing and treating esophageal foreign body impaction of a jujube pit and to determine the risk factors for complications.

Material and methods
We conducted a retrospective review of the medical records of patients who were diagnosed with esophageal impaction of a jujube pit. Demographic, clinical, radiological, and endoscopic data were collected and analyzed.

Results
Neither plain radiography nor esophagogram provided enough information on the surrounding issues and complications. The rate of secondary radiological examination was 51.61% for the patients who did not undergo prior computed tomography. The success rate of rigid esophagoscopy was 95.45%; 18 of these patients (27.27%) had previously undergone flexible esophagoscopy without foreign body removal. Logistic regression showed that the time from ingestion to presentation and the jujube pit size were independent risk factors for complications.

Conclusions
Computed tomography without contrast material is the preferred diagnostic method for adults with esophageal jujube pit impaction, and rigid esophagoscopy can be used for therapy even though the first flexible esophagoscopy failed. Large diameter of the jujube pit constituting the esophageal foreign body (≥ 25 mm) and long duration between pit ingestion and presentation (> 12 h) were associated with increased complications in the patients in this study.