Kalayci Ayhan, Tander Burak, Kocak Sule, Rizalar Riza, Bernay Ferit
Department of Pediatric Gastroenterology, Ondokuz Mayis University, Samsun, Turkey.
J Laparoendosc Adv Surg Tech A. 2007 Apr;17(2):242-5. doi: 10.1089/lap.2006.0060.
In our country, safety pin ingestion by infants is commonplace. When swallowed, open safety pins are mostly found within the esophagus or stomach, and they cannot be easily removed by rigid esophagogastroscopy. Our aim was to evaluate the removal of safety pins using flexible endoscopy in infants.
We evaluated the cases of 7 infants who had ingested open safety pins between 2001 and 2004. In all the patients, the primary diagnostic tool was a direct x-ray of the neck, chest, and abdomen. In all cases, the safety pins were removed by flexible esophagogastroduo-denoscopy. Clinical records for the cases were reviewed.
Four of the open safety pins were lodged in the esophagus, two in the stomach, and one in the duodenum. One infant had a safety pin lodged in the esophagus with the pin's open end pointed caudally; the pin was held with the endoscopic forceps by its tail end and removed. Three safety pins in the esophagus had their open ends pointing cephalad; these were held by their tail ends using the endoscopic forceps and pushed into the stomach. Then they were rotated in the stomach and removed tail end first. The safety pins located in the stomach or duodenum were also removed similarly. All safety pins were successfully removed, and there were no operative complications.
Open surgery or other invasive removal methods are not necessary in infants with open safety pin ingestions. In our opinion, the best way to extract an open safety pin from the esophagus, stomach, or duodenum is by using a flexible endoscopic device.
在我国，婴儿吞食安全别针的情况很常见。吞食后，打开的安全别针大多位于食管或胃内，通过硬质食管胃镜不易取出。我们的目的是评估在婴儿中使用柔性内镜取出安全别针的情况。
我们评估了2001年至2004年间7例吞食打开的安全别针的婴儿病例。所有患者的主要诊断工具是颈部、胸部和腹部的直接X线检查。所有病例均通过柔性食管胃十二指肠镜取出安全别针。对这些病例的临床记录进行了回顾。
4枚打开的安全别针位于食管，2枚位于胃，1枚位于十二指肠。1例婴儿食管内有一枚安全别针，开口端指向尾侧；用内镜钳夹住别针的尾端将其取出。食管内的3枚安全别针开口端指向头侧；用内镜钳夹住它们的尾端并将其推入胃内。然后在胃内旋转，先从尾端取出。位于胃或十二指肠内的安全别针也以类似方式取出。所有安全别针均成功取出，且无手术并发症。
对于吞食打开的安全别针的婴儿，无需进行开放手术或其他侵入性取出方法。我们认为，从食管、胃或十二指肠中取出打开的安全别针的最佳方法是使用柔性内镜设备。
