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纽扣电池吞食后小儿食管憩室。病例报告。

Pediatric esophageal diverticulum following button batter ingestion. A case report.

作者信息

Misso Kennedy Kisengo, Koipapi Sengua, Chilonga Kondo

机构信息

Department of General Surgery, Kilimanjaro Christian Medical Centre, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical University College, Tanzania.

Department of General Surgery, Kilimanjaro Christian Medical Centre, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical University College, Tanzania.

出版信息

Int J Surg Case Rep. 2023 Sep;110:108665. doi: 10.1016/j.ijscr.2023.108665. Epub 2023 Aug 20.

Abstract

INTRODUCTION AND SIGNIFICANCE

Foreign body ingestion is a frequent and potentially life-threatening concern in children, with button batteries being the second most frequently ingested object trailing coins. The mechanical and chemical impact of foreign objects on delicate esophageal lumen poses a grave concern.

CASE PRESENTATION

Herein, we unveil a compelling case of a two-year-old girl who suffered from difficulty in swallowing, weight loss, and frequent chest infections. A chest X-ray revealed a halo sign within the confines of her thoracic esophagus. However, the formidable challenge of extensive inflammation greatly hindered visibility during esophagoscopy, leading to an imperative decision of thoracotomy. The surgical exploration uncovered an esophageal diverticulum, skillfully managed with a conservative approach. Three months postoperatively, she resumed regular feeds without chest symptoms.

DISCUSSION

Foreign body ingestion is predominantly among children below four years, with button batteries being among the frequent objects involved. Endoscopic retrieval is an effective and less morbid procedure for foreign body retrieval. Esophageal diverticula following button battery ingestion have rarely been reported.

CONCLUSION

Timely diagnosis and effective management of esophageal foreign bodies are crucial, as chemical reactions from button batteries can commence within two hours of ingestion. Swift and decisive actions, coupled with less morbid procedures such as endoscopic retrieval should be prioritized in the management.

摘要

引言与意义

异物摄入是儿童常见且可能危及生命的问题,纽扣电池是第二常见的被摄入物体,仅次于硬币。异物对脆弱的食管腔产生的机械和化学影响令人严重担忧。

病例介绍

在此,我们揭示了一例引人关注的病例,一名两岁女孩出现吞咽困难、体重减轻和频繁的胸部感染。胸部X线显示其胸段食管范围内有晕征。然而,广泛炎症带来的巨大挑战严重妨碍了食管镜检查时的视野,导致必须进行开胸手术。手术探查发现一个食管憩室,采用保守方法成功处理。术后三个月,她恢复正常喂食,胸部无症状。

讨论

异物摄入主要发生在四岁以下儿童中,纽扣电池是常见的相关物体。内镜取出是一种有效且创伤较小的异物取出方法。纽扣电池摄入后导致食管憩室鲜有报道。

结论

及时诊断和有效处理食管异物至关重要,因为纽扣电池摄入后两小时内即可开始发生化学反应。在处理过程中应优先采取迅速果断的行动,并优先选择如内镜取出等创伤较小的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc2f/10509801/969603092d7f/gr1.jpg

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