Destro Francesca, Caruso Anna Maria, Mantegazza Cecilia, Maestri Luciano, Meroni Milena, Pederiva Federica, Milazzo Mario, Acierno Carlo, Zuccotti Gianvincenzo, Calcaterra Valeria, Pelizzo Gloria
Pediatric Surgery Department, Children's Hospital "Vittore Buzzi", 20154 Milan, Italy.
Pediatric Surgery Unit, G. Di Cristina Children's Hospital, 90121 Palermo, Italy.
Children (Basel). 2021 Oct 23;8(11):956. doi: 10.3390/children8110956.
Children with intellectual disability/neurodevelopmental delay (ID-ND) commonly ingest foreign bodies (FB) and often present complications due to peculiar aspects of their condition. The aim of this paper is to report the experience of two centers in the management of ID-ND patients after FB ingestion and to discuss a possible algorithm for clinical practice. We retrospectively evaluated data of patients managed for FB ingestion (period: 2017-2021), focusing on those with ID-ND, specifically demographics and baseline diagnosis, elements related to the event, symptoms, time to endoscopy, FB location, endoscopic details, and follow-up. A total of 457 patients were managed in the study period and 19 had ID-ND (mean age 9.8 ± 3.5 years, 15 males). A total of 16/19 (84.2%) were symptomatic and required an operative approach. Recurrent ingestions and multiple FB were found in 2 and 11 patients, respectively. Endoscopy (mean time 65.6 ± 41 min) was effective in 14 cases (73.6%) and 6 patients (31.6%) developed a complication. FB ingestion in ID-ND patients represents a challenging condition for the clinician and a potentially dangerous situation. It should be addressed specifically by a multidisciplinary team considering a tailored diagnostic and management protocol.
患有智力残疾/神经发育迟缓（ID-ND）的儿童通常会吞食异物（FB），并且由于其病情的特殊方面常常出现并发症。本文的目的是报告两个中心在管理ID-ND患者吞食异物后的经验，并讨论一种可能的临床实践算法。我们回顾性评估了因吞食异物而接受治疗的患者的数据（时间段：2017年至2021年），重点关注患有ID-ND的患者，具体包括人口统计学和基线诊断、与事件相关的因素、症状、内镜检查时间、异物位置、内镜检查细节以及随访情况。在研究期间共管理了457例患者，其中19例患有ID-ND（平均年龄9.8±3.5岁，15例为男性）。共有16/19（84.2%）出现症状并需要手术治疗。分别在2例和11例患者中发现反复吞食和多个异物。内镜检查（平均时间65.6±41分钟）在14例（73.6%）患者中有效，6例（31.6%）患者出现并发症。ID-ND患者吞食异物对临床医生来说是一个具有挑战性的情况，也是一种潜在的危险情况。应由多学科团队考虑制定量身定制的诊断和管理方案来专门处理。
