Arana A, Hauser B, Hachimi-Idrissi S, Vandenplas Y
Academisch Ziekenhuis Kinderen, Vrije Universiteit Brussel, Belgium.
Eur J Pediatr. 2001 Aug;160(8):468-72. doi: 10.1007/s004310100788.
The management of ingested foreign bodies in children is not standardised. During a 15-year period, we recorded 325 consecutive paediatric cases of accidental ingestion of foreign bodies or with symptoms suggesting oesophageal obstruction presented at the emergency department or the paediatric gastroenterology unit. The foreign bodies that had to be removed were, in decreasing order of frequency: coins, toy parts, jewels, batteries, sharp materials such as needles and pins, fish and chicken bones, and "large" amounts of food. Only 54% of the patients had transient symptoms at the moment of ingestion, such as retrosternal pain, cyanosis and dysphagia. A minority (28, 9%) of foreign bodies could be removed with a McGill forceps; 65 (20%) were removed with a magnet probe. Endoscopic removal was performed in 82 cases (25%). In the majority of cases (150, 46%) natural elimination occurred. The outcome of all patients was uneventful.
Recommendations for management of children presenting with a history of suspected accidental ingestion of a foreign body for the community paediatrician are proposed.
儿童摄入异物的处理方法尚未标准化。在15年期间,我们记录了连续325例儿科病例,这些病例是在急诊科或儿科胃肠病科出现意外摄入异物或有提示食管梗阻症状的患儿。需要取出的异物按出现频率从高到低依次为:硬币、玩具部件、珠宝、电池、针和大头针等尖锐物品、鱼骨和鸡骨以及“大量”食物。只有54%的患者在摄入异物时出现短暂症状,如胸骨后疼痛、发绀和吞咽困难。少数(28.9%)异物可用麦吉尔镊子取出;65例(20%)用磁探针取出。82例(25%)进行了内镜取出。大多数病例(150例,46%)异物自然排出。所有患者的结局均平稳。
针对社区儿科医生,提出了对有疑似意外摄入异物病史儿童的处理建议。