Diaconescu Smaranda, Gimiga Nicoleta, Sarbu Ioan, Stefanescu Gabriela, Olaru Claudia, Ioniuc Ileana, Ciongradi Iulia, Burlea Marin
"Gr. T. Popa" University of Medicine and Pharmacy, Strada Universitatii, No. 16, 700115 Iasi, Romania; "St. Mary" Emergency Hospital for Children, Strada Vasile Lupu, No. 62, 700309 Iasi, Romania.
"Gr. T. Popa" University of Medicine and Pharmacy, Strada Universitatii, No. 16, 700115 Iasi, Romania; "St. Spiridon" Emergency Hospital, Bulevardul Independentei, No. 1, 700111 Iasi, Romania.
Gastroenterol Res Pract. 2016;2016:1982567. doi: 10.1155/2016/1982567. Epub 2016 Feb 1.
The ingestion of foreign bodies is a worldwide pediatric pathology. We assessed the clinical, endoscopic, and therapeutic aspects of this condition in a pediatric gastroenterology unit. We reviewed 61 patients (median age of 3.25 ± 4.7 years). The most frequently ingested objects were coins (26.23%), unidentified metal objects (13.11%), bones (8.19%), batteries, and buttons (6.55%). The clinical features we encountered included abdominal pain (55.73%), vomiting (34.42%), and asymptomatic children (29.5%). Routine X-ray examination enabled finding the foreign body in 42 of the cases. An esophagogastroduodenoscopy was performed within 24-72 hours. 25 cases resulted in a negative endoscopy (40.98%), 19 objects (31.14%) were removed using a polypectomy snare, and extraction failure occurred in 17 patients (27.86%). 28 foreign bodies were passed without incidents; in 14 cases, the swallowed objects were never found. In one case, a battery was stuck in the esophageal folds and led to tracheal-esophageal fistula and bronchopneumonia and later to esophageal stenosis. We report a large proportion of foreign bodies that could not be identified or removed due to lack of early endoscopy and poor technical settings. Batteries and sharp objects lead to severe complications and preschool-age children are at high risk for such events.
异物摄入是一种全球性的儿科病理情况。我们在一个儿科胃肠病科评估了这种情况的临床、内镜检查及治疗方面。我们回顾了61例患者（中位年龄3.25±4.7岁）。最常摄入的物体是硬币（26.23%）、不明金属物体（13.11%）、骨头（8.19%）、电池和纽扣（6.55%）。我们遇到的临床特征包括腹痛（55.73%）、呕吐（34.42%）以及无症状儿童（29.5%）。常规X线检查在42例病例中发现了异物。在24至72小时内进行了食管胃十二指肠镜检查。25例内镜检查结果为阴性（40.98%），19个物体（31.14%）通过息肉切除圈套器取出，17例患者（27.86%）取出失败。28个异物顺利排出；14例中，吞咽的物体未被发现。1例中，一枚电池卡在食管皱襞处，导致气管食管瘘和支气管肺炎，随后发展为食管狭窄。我们报告了很大一部分异物由于缺乏早期内镜检查和技术条件不佳而无法识别或取出。电池和尖锐物体可导致严重并发症，学龄前儿童发生此类事件的风险很高。
