Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

Eunsook Choi, H. G. Lee, Soojinna Choi, S. Chung
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引用次数: 4

Abstract

Foreign body ingestion is a common problem among paediatric populations. Most of the ingested foreign bodies spontaneously pass through the gastrointestinal tract, but approximately less then 10% of them remain without being discharged, and trigger complications. Therefore, proper evaluation and treatment according to the situation is required. In this study, clinical progress and complications were analyzed according to the clinical features and treatment in children who ingested foreign bodies. Among pediatric patients under 18 who were admitted to Chonnam National University Hospital after ingesting foreign bodies between January 2008 to June 2012, only the patients who had their foreign body in the gastrointestinal tract were included in this study. Based on medical records, age, type of foreign body, time spent till admission, and whether the endoscopy was done or not, complication were researched retrospectively. According to symptoms and plain abdomen X-ray findings, treatment was chosen and conducted among endoscopy, observation and emergency operation. Among 273 patients, 9 (3.3%) of them had surgical removal. Seven (2.6%) of them had an emergency operation on the day of admission, and the rest 2 (0.7%) had operation during observation. Removal through initial endoscopic approach was tried in 157 (57.5%) patients. Eleven (70.8%) of them had their foreign body removed at the initial trial, and 5 (4.9%) of them at the second trial. Among 109, who were on observation status, 9 (8.3%) of them needed endoscopic removal, and 2 (1.8%) of them suffered from surgical removal. It is thought to be better to approach slowly considering the type, size and symptoms in foreign body ingestion of pediatric patients, rather than immediate and invasive removal.
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儿童胃肠道异物临床分析
异物摄入是儿科人群的常见问题。大多数被摄入的异物会自发地通过胃肠道,但只有不到10%的异物没有排出体外,并引发并发症。因此,需要根据情况进行适当的评估和处理。本研究根据小儿误食异物的临床特点及治疗方法,对其临床进展及并发症进行分析。在2008年1月至2012年6月期间,在全南大学医院因摄入异物而入院的18岁以下儿童患者中,仅纳入了胃肠道中有异物的患者。根据患者的病历、年龄、异物类型、入院时间及是否行内镜检查,回顾性分析并发症。根据症状及腹部x线平片表现,在内镜、观察、急诊手术中选择治疗方案。273例患者中有9例(3.3%)行手术切除。入院当天急诊手术7例(2.6%),观察期间手术2例(0.7%)。157例(57.5%)患者尝试通过初始内镜入路切除。其中11例(70.8%)在第一次试验中取出了异物,5例(4.9%)在第二次试验中取出了异物。109例观察患者中,内镜下切除9例(8.3%),手术切除2例(1.8%)。考虑到儿科患者异物摄入的类型、大小和症状,我们认为最好是慢慢接近,而不是立即和侵入性清除。
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