Choe Jae Young, Choe Byung-Ho
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.
Pediatr Gastroenterol Hepatol Nutr. 2019 Mar;22(2):132-141. doi: 10.5223/pghn.2019.22.2.132. Epub 2019 Mar 5.
Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).
儿童吞食异物是一种常见的儿科急症，需要医疗关注。儿科急诊医生和胃肠病学家在日常临床实践中经常遇到因儿童出现这种情况而导致的紧张和棘手的状况。在确定适当的干预时机和指征时，医生应考虑多个与患者和异物相关的因素。在这些病例中，使用柔性内镜被认为是安全有效的，成功率高，可有效从儿童胃肠道中取出异物。此外，几十年来，Foley导管和带磁铁的Levin管一直用于异物取出。尽管近年来它们的使用显著减少，但这些器械仍用于多种指征。使用Foley导管进行此操作不需要特殊培训，也不一定需要对患者进行镇静或使用荧光镜检查，这些都是利用该方法进行异物取出的优势。吞食的磁铁或含铁异物可用带磁铁的管子取出，对从可到达的上消化道任何部位取出异物都有效。如果不能立即进行内镜检查（如在农村地区和/或午夜在医疗机构就诊的患者，特别是那些无法使用内镜或紧急服务的患者，或在任何需要紧急取出异物的情况下），Foley导管和带磁铁的管子等简单且廉价的器械可用于诸如纽扣电池食管嵌顿等紧急情况。
