探讨影像学检查及消化内镜在儿童消化道异物诊断与治疗，尤其是在病史不明、病程迁延的复杂病例中的应用价值。

报道2例因吞咽困难就诊、无明确异物误吞史的食管狭窄患儿病例，分享诊疗经过，分析影像学与消化内镜技术在诊断及治疗中的具体应用，为临床诊疗工作提供思路。

2例患儿均经电子胃镜检查于狭窄部位发现嵌顿异物(家长事后追忆起半年余、2年前的异物误吞史)，最终确诊为食管异物。均于手术室行内镜下异物取出术，术中采用钩刀放射状切开、圈套器分片切除增生的肉芽组织，分离暴露异物后，借助异物钳及导丝成功取出异物。病例1术中发现食管穿孔及气胸，予胸腔闭式引流并置入覆膜可回收食管支架；病例2并发食管穿孔及溃疡，置入胃肠营养管及食管引流管。术后2例患儿因继发性食管狭窄定期接受内镜下食管狭窄治疗。随访至今，2例患者均可经口正常进食，生长发育良好。

食管异物嵌顿是儿童后天性食管狭窄的常见病因。对于异物误吞史不明、嵌顿时间长、并发症风险高的病例，应重视影像学与消化内镜的细致评估，以获取关键诊断线索，助力最优治疗决策。术前多学科协作评估、术中精细内镜操作，有助于有效处理并发症，避免不必要的外科手术。同时，应加强公众健康教育，提高对儿童消化道异物的认识，促进早期诊治。

To explore the application value of imaging examinations and digestive endoscopy in the diagnosis and treatment of gastrointestinal foreign body in children, especially in complicated cases with unclear history and protracted course.

Two cases of esophageal stenosis in children with dysphagia and no clear history of foreign body ingestion were reported, and the diagnosis and treatment process was shared.The specific application of imaging and endoscopic techniques in diagnosis and treatment was analyzed, providing ideas for clinical diagnosis and treatment.

Both cases were ultimately diagnosed with esophageal foreign bodies via electronic gastroscopy, which revealed impacted foreign bodies at the stricture sites (the parents later recalled histories of foreign body ingestion over 6 months and 2 years prior, respectively).Both children underwent endoscopic foreign body removal in the operating room.Intraoperatively, hook knives were used for gradual radial incisions, and snare devices were employed to piecemeal resect locally hyperplastic granulation tissue.After dissection and exposure of the foreign bodies, they were successfully removed using foreign body forceps combined with guidewires.In Case 1, esophageal perforation and pneumothorax were detected during the procedure, and closed thoracic drainage with placement of a covered retrievable esophageal stent was performed for perforation sealing.In Case 2, esophageal perforation and ulceration were complicated, and a nasogastric feeding tube along with an esophageal drainage tube was inserted. Postoperatively, both patients received regular endoscopic treatment for secondary esophageal strictures.To date, both patients are able to eat normally via the oral route and show satisfactory growth and development.

Esophageal foreign body impaction is a common cause of acquired esophageal stenosis in children.For cases with unclear history of foreign body ingestion, long time of impaction, and high risk of complications, attention should be paid to the detailed evaluation of imaging and digestive endoscopy to obtain key diagnostic clues and assist in making the optimal treatment decision.Multidisciplinary preoperative evaluation and precise endoscopic operation during surgery can help effectively deal with complications and avoid unnecessary surgical operations.At the same time, public health education should be strengthened to raise awareness of gastrointestinal foreign bodies in children and promote early diagnosis and treatment.