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儿童跨越胃食管交界处异物的处理

Management of Foreign Bodies Crossing the Gastroesophageal Junction in Children.

作者信息

Dursun Ahmet, Öztaş Tülin

机构信息

Department of Pediatric Surgery, University of Health Sciences, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.

出版信息

Turk Arch Pediatr. 2023 Nov;58(6):607-611. doi: 10.5152/TurkArchPediatr.2023.23023.

Abstract

OBJECTIVE

Foreign body (FB) ingestion is a common problem in children and is an important public health problem in terms of causing serious complications. This study aims to evaluate the complication management and intervention rates of FBs crossing the gastroesophageal junction.

MATERIALS AND METHODS

The hospital records of all children who presented to our clinic because of ingestion of FB between August 2019 and August 2021 were retrospectively reviewed. Patients who had an FB crossing the esophagogastric junction on plain radiographs showing the entire gastrointestinal tract taken at the time of admission were included in this study. Patients who had an FB removed from the esophagus by endoscopy were excluded from this study.

RESULTS

Of the 127 patients included in this study, 66 (52%) were male and 61 (48%) were female, with a mean age of 4.94 ± 3.15 years (3 months-17 years), and 59% (n = 75) of the patients were under 5 years of age. The most common type of FB was a coin (47%). The first pediatric cases in the literature were a clothespin discovered in the stomach and a Meckel's diverticulum perforated by a sunflower seed shell. Management included spontaneous passing (89%), endoscopy (7%), and open surgery (4%).

CONCLUSION

Although FBs passing through the esophagogastric junction may be asymptomatic in most cases, the need for close monitoring and surgical intervention should be kept in mind in these patients.

摘要

目的

异物吞食是儿童常见问题,就引发严重并发症而言,也是一个重要的公共卫生问题。本研究旨在评估穿过胃食管交界处的异物的并发症处理情况及干预率。

材料与方法

回顾性分析2019年8月至2021年8月因吞食异物前来我院就诊的所有儿童的医院记录。本研究纳入了入院时拍摄的显示整个胃肠道的X线平片上有异物穿过食管胃交界处的患者。通过内镜从食管取出异物的患者被排除在本研究之外。

结果

本研究纳入的127例患者中,男性66例(52%),女性61例(48%),平均年龄4.94±3.15岁(3个月至17岁),59%(n = 75)的患者年龄在5岁以下。最常见的异物类型是硬币(47%)。文献中首例儿科病例是在胃中发现的一个衣夹和一枚被葵花籽壳穿孔的梅克尔憩室。处理方式包括自行排出(89%)、内镜检查(7%)和开放手术(4%)。

结论

尽管大多数情况下,穿过食管胃交界处的异物可能无症状,但对这些患者仍应密切监测并牢记手术干预的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef3c/10724748/1cc180b418a5/tap-58-6-607_f001.jpg

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