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食管叉骨取出术:胆小者勿试。

Esophageal wishbone extraction: not for the chicken-hearted.

作者信息

Mondin Robert M, Fandiño Marcela, Carpes Luthiana F, Tang Judy, Ogilvie Lauren N, Kozak Frederick K

机构信息

Division of Pediatric Otolaryngology, BC Children's Hospital, Vancouver, British Columbia, Canada.

Division of Pediatric Otolaryngology, BC Children's Hospital, Vancouver, British Columbia, Canada

出版信息

Ann Otol Rhinol Laryngol. 2015 Jan;124(1):79-82. doi: 10.1177/0003489414541422. Epub 2014 Jul 1.

Abstract

OBJECTIVE

Ingestion of foreign bodies in the pediatric population is common and in the majority of cases involves spontaneous passage through the esophagus; however, they can become lodged in spaces of anatomical narrowing. Sharp foreign bodies are of particular concern due to a higher chance of perforation and other complications. The goal of this case report is to describe the safe removal of a chicken wishbone and 3 alternate options in the event that the initial choice was unsuccessful.

METHODS

We report the case of a 2-year-old boy who presented to our pediatric tertiary center after unsuccessful endoscopic removal of a chicken wishbone from the esophagus.

RESULTS

Radiologically, the wishbone was oriented with the tines pointing up. Endoscopic examination revealed the tips of both tines to be embedded deeply into the lateral walls of the esophageal mucosa. Esophagoscopy and protecting the sharp points of the wishbone were used to successfully extract the intact wishbone.

CONCLUSION

Previous techniques have involved cutting the bone; however, in this case, tension was so high that it was felt that cutting the bone would result in perforation. Proper management of such cases requires planning and often multiple strategies.

摘要

目的

小儿吞食异物很常见,大多数情况下异物会自行通过食管;然而,它们可能会卡在解剖结构变窄的部位。尖锐异物尤其令人担忧,因为穿孔和其他并发症的发生几率更高。本病例报告的目的是描述鸡叉骨的安全取出过程,以及在初始选择不成功时的其他三种选择。

方法

我们报告了一名2岁男孩的病例,他在内镜下从食管取出鸡叉骨失败后,来到我们的儿科三级中心。

结果

放射学检查显示,鸡叉骨的叉尖向上。内镜检查发现两个叉尖都深深嵌入食管黏膜的侧壁。通过食管镜检查并保护鸡叉骨的尖锐部位,成功完整地取出了鸡叉骨。

结论

以前的技术是将骨头切断;然而,在本病例中,张力非常高,认为切断骨头会导致穿孔。对此类病例的妥善处理需要规划,通常还需要多种策略。

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