Quitadamo Paolo, Battagliere Ilaria, Del Bene Margherita, Caruso Flora, Gragnaniello Piergiorgio, Dolce Pasquale, Caldore Mariano, Bucci Cristina
From the Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
the Department of Translational Medical Science, Section of Pediatrics, University "Federico II", Naples, Italy.
J Pediatr Gastroenterol Nutr. 2023 Feb 1;76(2):213-217. doi: 10.1097/MPG.0000000000003655. Epub 2022 Nov 8.
To assess the clinical complications reported after the ingestion of sharp/pointed foreign bodies (FBs) in pediatric age, their incidence among all FB ingestions, and the features and clinical presentation of children.
We have recruited all consecutive patients aged 0-14 years, admitted for sharp/pointed FB ingestion. Clinical data until hospital discharge were accurately recorded, including both children with esophagogastric FB retention who underwent endoscopic removal and children who were radiologically followed-up till spontaneous FB expulsion. Clinical outcomes were recorded for each patient, with special reference to possible prolonged retention and wall perforation during the intestinal passage.
We have enrolled 580 children (males/females: 292/288; age range: 11-180 months; mean age ± standard deviation: 50.5 ± 42 months). Sharp/pointed FBs mainly included fragments of metal 270 of 580 (46.55%) and glass 180 of 580 (31%). FBs were endoscopically removed in 79 of 580 (13.6%) children whereas the remaining FBs passed through the gastrointestinal tract over an overall mean time of 29 hours. No cases of intestinal perforation nor prolonged retention were observed. In 3 of 65 (4.6%) procedures the endoscopist faced an uncomfortable endoscopic removal due to the shape and size of the FB which hampered the retrograde passage through the esophageal sphincters.
Our original and extensive data emphasize that accidental ingestion of sharp/pointed FB ingestion is a current issue in pediatric age, especially in toddlers. Metal and glass objects are the most involved FBs and their endoscopic retrieval may not be easy in about 5% of cases. Fortunately, in our pediatric sample no surgical intervention was needed.
评估小儿吞食尖锐/带尖异物（FBs）后报告的临床并发症、其在所有FBs吞食病例中的发生率以及儿童的特征和临床表现。
我们招募了所有连续收治的0至14岁因吞食尖锐/带尖FBs入院的患者。准确记录直至出院的临床数据，包括接受内镜取出食管胃FBs滞留的儿童以及接受放射学随访直至FBs自然排出的儿童。记录每位患者的临床结局，特别关注肠道通过期间可能的长时间滞留和肠壁穿孔。
我们纳入了580名儿童（男/女：292/288；年龄范围：11 - 180个月；平均年龄±标准差：50.5±42个月）。尖锐/带尖FBs主要包括金属碎片580例中的270例（46.55%）和玻璃碎片580例中的180例（31%）。580名儿童中有79名（13.6%）通过内镜取出FBs，其余FBs通过胃肠道的总平均时间为29小时。未观察到肠穿孔和长时间滞留病例。在65例操作中的3例（4.6%）中，由于FB的形状和大小阻碍了通过食管括约肌的逆行通过，内镜医师面临不舒服的内镜取出情况。
我们原始且广泛的数据强调，意外吞食尖锐/带尖FBs是小儿年龄段当前存在问题，尤其是在幼儿中。金属和玻璃物体是最常涉及的FBs，约5%的病例中其内镜取出可能并不容易。幸运的是，在我们的小儿样本中无需手术干预。
