Oncel Murat, Sunam Guven Sadi, Elsurer Cagdas, Yildiran Huseyin
Department of Thoracic Surgery, Medical Faculty, Selcuk University, Konya, Turkey.
Department of Otorhinolaryngology, Medical Faculty, Selcuk University, Konya, Turkey.
Surg J (N Y). 2017 Jun 19;3(2):e91-e95. doi: 10.1055/s-0037-1604102. eCollection 2017 Apr.
Esophageal foreign body (FB) in all age groups can cause serious morbidity or mortality. The study aims to report our experience retrieving FBs from the upper esophagus in children using Magill forceps. In this study, 88 patients (45 males [51.1%] and 43 females [48.9%]) were presented with suspected FB ingestion. FB ingestion was determined via endoscopic analysis, or lateral and posterior-anterior radiographies, including oropharynx, neck, chest, and abdomen. Cases were classified into seven groups, according to history, diagnostic method, and postintervention findings, as follows: (1) coins, (2) toys, (3) metals, (4) bones, (5) battery, (6) glass, and (7) food. A laryngoscope was used to elevate the larynx and expose the esophageal entrance. Magill forceps were advanced into the esophagus and opened to observe and extract the FB. All 88 patients who underwent endoscopic examination due to suspected FB ingestion were confirmed to have ingested a FB. Median age was 12 years; 15 patients were aged < 5 years; 63 (71.5%) were diagnosed based on routine radiographic findings, and others were diagnosed based on physical findings and history. The most common type of FB was coins ( = 51 [57.9%]). Mean surgical duration was 20 minutes. FBs located at cervical esophageal level are usually the most difficult to remove. Magill forceps should be used before other methods.
各年龄组的食管异物均可导致严重的发病或死亡。本研究旨在报告我们使用麦吉尔钳从儿童上段食管取出异物的经验。
在本研究中,88例患者(45例男性[51.1%],43例女性[48.9%])因疑似异物摄入就诊。通过内镜分析或包括口咽、颈部、胸部和腹部的侧位及前后位X线摄影确定异物摄入情况。根据病史、诊断方法和干预后结果,病例分为七组,如下:(1)硬币,(2)玩具,(3)金属,(4)骨头,(5)电池,(6)玻璃,(7)食物。使用喉镜抬高喉部并暴露食管入口。将麦吉尔钳推进食管并打开以观察和取出异物。
所有88例因疑似异物摄入而接受内镜检查的患者均被证实摄入了异物。中位年龄为12岁;15例患者年龄<5岁;63例(71.5%)根据常规X线检查结果确诊,其他患者根据体格检查和病史确诊。最常见的异物类型是硬币(n = 51 [57.9%])。平均手术时间为20分钟。
位于颈段食管水平的异物通常最难取出。在使用其他方法之前应先使用麦吉尔钳。