Vyas K, Sawant P, Rathi P, Das H S, Borse N
Department of Gastroenterology, LT Municipal Medical College and LT Municipal General Hospital, Sion, Mumbai.
J Assoc Physicians India. 2000 Apr;48(4):394-6.
Foreign body ingestion is common and a frightening experience to the patients and relatives. We report our experience with 102 patients, (78 children and 24 adults), with foreign body ingestion.
After locating foreign bodies radiologically, 34 (43.6%) foreign bodies in children and 13 (54.2%) foreign bodies in adults were removed endoscopically. General anesthesia was used in 32 children and overtube was used for all sharp foreign bodies.
In our study, 78 (76%) patients were below 12 years of age. Coins (79.5%) were commonest foreign bodies in children while dentures (25%) were commonest in adults. Foreign bodies were most commonly sited in stomach (25.6%) in children and esophagus (58.3%) in adults. In 41 (52.6%) children and in three (12.5%) adults, i.e. total 44 out of 102 (43.1%) patients passed foreign bodies spontaneously. The largest foreign body that passed spontaneously was 4-cm long nail in a child. In 34 (43.6%) children and in 13 (54.2%) adults foreign bodies were removed endoscopically. Only 3.8% children and 33.3% adults required surgery.
There was no mortality in our series. Majority of foreign bodies do not require any intervention. Sharp foreign bodies are commonest indication for surgery. However, endoscopic removal is safe, effective and is the method of choice for most patients.
异物摄入很常见,对患者及其亲属来说是一次可怕的经历。我们报告了102例异物摄入患者(78名儿童和24名成人)的治疗经验。
通过放射学定位异物后,34例(43.6%)儿童异物和13例(54.2%)成人异物通过内镜取出。32名儿童使用了全身麻醉,所有尖锐异物均使用了外套管。
在我们的研究中,78例(76%)患者年龄在12岁以下。硬币(79.5%)是儿童中最常见的异物,而假牙(25%)是成人中最常见的异物。异物最常见于儿童的胃(25.6%)和成人的食管(58.3%)。41例(52.6%)儿童和3例(12.5%)成人,即102例患者中的44例(43.1%)自行排出了异物。自行排出的最大异物是一名儿童体内4厘米长的钉子。34例(43.6%)儿童和13例(54.2%)成人的异物通过内镜取出。仅3.8%的儿童和33.3%的成人需要手术。
我们的系列研究中无死亡病例。大多数异物无需任何干预。尖锐异物是手术的最常见指征。然而,内镜取出是安全、有效的,是大多数患者的首选方法。