Ramgopal Sriram, Ramprasad Vaibhav H, Manole Mioara D, Maguire Raymond C
Division of Pediatric Emergency Medicine, Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Division of Pediatric Otolaryngology, Department of Otolaryngology- Head and Neck Surgery, UPMC, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
J Emerg Med. 2019 Jun;56(6):e115-e117. doi: 10.1016/j.jemermed.2019.02.016. Epub 2019 Apr 17.
Superabsorbent polymers (SAPs) are materials that can absorb large quantities of water. Small spherical SAPs are commonly marketed as toys for children.
We report the case of a 4-year-old female who presented to a pediatric emergency department with a small, marble-sized SAP that was placed in her ear by herself during the course of play at daycare. On examination, the object was translucent and difficult to visualize. After multiple attempts at removal, the object was partially removed using an ear curette. The patient sustained a small tympanic membrane perforation. During a follow-up operative intervention by otorhinolaryngology, the remainder of the object was removed using a suction device and the tympanic membrane was repaired. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: While large SAPs associated with intestinal obstruction have been removed from the market, smaller SAPs can present a health risk when placed in orifices such as the ear or nose. Cases of foreign body SAPs have been misdiagnosed as ear infections and treated with topical antibiotics, which can lead to enlargement of the foreign body. Irrigation techniques and topical medications should not be used. SAPs are friable and can break into multiple pieces during removal attempts. Blunt tools, such as ear curettes, may be best suited for their removal. If the item breaks up during removal or if removal fails, urgent consultation with an otorhinolaryngologist is recommended.
高吸水性聚合物(SAPs)是能够吸收大量水分的材料。小型球形SAPs通常作为儿童玩具销售。
我们报告一例4岁女性患儿,她因一个弹珠大小的小型SAP在日托中心玩耍时自行放入耳中,而被送至儿科急诊科。检查时,该物体呈半透明状,难以看清。经过多次尝试取出后,使用耳刮匙部分取出了该物体。患儿鼓膜出现一个小穿孔。在后续的耳鼻喉科手术干预中,使用吸引装置取出了物体的剩余部分,并修复了鼓膜。为什么急诊医生应该了解这个情况?:虽然与肠梗阻相关的大型SAPs已从市场上移除,但较小的SAPs放入耳朵或鼻子等孔窍时会带来健康风险。异物SAPs的病例曾被误诊为耳部感染并用局部抗生素治疗,这可能导致异物增大。不应使用冲洗技术和局部用药。SAPs易碎,在尝试取出过程中可能会破碎成多块。钝器,如耳刮匙,可能最适合用于取出它们。如果在取出过程中物品破碎或取出失败,建议紧急咨询耳鼻喉科医生。