Gezer Hasan Özkan, Ezer Semire Serin, Temiz Abdulkerim, İnce Emine, Hiçsönmez Akgün
Department of Pediatric Surgery, Başkent University Faculty of Medicine, Adana-Turkey.
Ulus Travma Acil Cerrahi Derg. 2020 Mar;26(2):247-254. doi: 10.14744/tjtes.2019.40350.
Foreign body (FB) ingestion is frequently encountered in all departments that treat children. FB may bring about significant anxiety for parents and physicians. The present study aims to determine the appropriate approach for FB ingestion in children.
The records of 1000 children with a history of FB ingestion between the years 2005 and 2017 were reviewed retrospectively in this study.
Of 1000 children, 53.8% were male. The most common types of FBs were coins (35%). X-ray was negative in 49% of the patients, and 86% of these patients received no intervention. Of the 504 (51%) X-ray-positive patients, the oesophagus (68%) was the most common location. Life-threatening complications were tracheo-oesophageal fistula (1), Meckel's diverticulum perforation (1), and perforation due to rigid endoscopy (1).
We demonstrated that coins, which are the most commonly ingested FBs, have various types and sizes according to their countries of origin, and this affects spontaneous passage. We found that only 48% (quite low compared to the literature) of the coins passed spontaneously. In asymptomatic patients with a gastric button battery, we suggest a "watchful waiting" approach. The patients should be observed and managed at home. In our study, we found that 85% of the button batteries that reached the stomach passed spontaneously.
在所有治疗儿童的科室中，异物（FB）摄入情况屡见不鲜。异物可能会给家长和医生带来极大的焦虑。本研究旨在确定儿童异物摄入的合适处理方法。
本研究回顾性分析了2005年至2017年间1000例有异物摄入史儿童的记录。
1000例儿童中，53.8%为男性。最常见的异物类型是硬币（35%）。49%的患者X线检查为阴性，其中86%的患者未接受干预。在504例（51%）X线阳性患者中，食管（68%）是最常见的部位。危及生命的并发症有气管食管瘘（1例）、梅克尔憩室穿孔（1例）和硬性内镜检查导致的穿孔（1例）。
我们证明，作为最常摄入的异物，硬币根据其原产国不同有多种类型和尺寸，这会影响其自行排出。我们发现只有48%的硬币能自行排出（与文献相比相当低）。对于无症状的胃内纽扣电池患者，我们建议采用“密切观察等待”的方法。患者应在家中接受观察和处理。在我们的研究中，我们发现85%进入胃内的纽扣电池能自行排出。
