Department of Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, 56 Nanlishi Road, Xicheng District, 100045, Beijing, China.
Department of Surgery, Beijing United Family Hospital, 100015, Beijing, China.
BMC Pediatr. 2024 Jan 3;24(1):5. doi: 10.1186/s12887-023-04425-z.
In this study, we aimed to enhance the treatment protocols and help understand the harm caused by the accidental ingestion of magnetic beads by children.
Data were collected from 72 children with multiple gastrointestinal perforations or gastrointestinal obstructions. The 72 pediatric patients were divided into a perforation and a non-perforation group. The data collected for the analysis included the gender, age, medical history, place of residence (rural or urban), and symptoms along with the educational background of the caregiver, the location and quantity of any foreign bodies discovered during the procedure, whether perforation was confirmed during the procedure, and the number of times magnetic beads had been accidentally ingested.
The accuracy rate of preoperative gastrointestinal perforation diagnosis via ultrasound was 71%, while that of the upright abdominal X-ray method was only 46%. In terms of symptoms, the risk of perforation was 13.844 and 12.703 times greater in pediatric patients who experienced vomiting and abdominal pain with vomiting and abdominal distension, respectively, compared to patients in an asymptomatic state. There were no statistical differences between the perforation and the non-perforation groups in terms of age, gender, medical history, and the number of magnetic beads ingested (P > 0.05); however, there were statistical differences in terms of white blood cell count (P = 0.048) and c-reactive protein levels (P = 0.033). A total of 56% of cases underwent a laparotomy along with perforation repair and 19% underwent gastroscopy along with laparotomy. All pediatric patients recovered without complications following surgery.
Abdominal ultrasonography and/or upright abdominal X-ray analyses should be carried out as soon as possible in case of suspicion of accidental ingestion of magnetic beads by children. In most cases, immediate surgical intervention is required. Given the serious consequences of ingesting this type of foreign body, it is essential to inform parents and/or caregivers about the importance of preventing young children from using such products.
本研究旨在增强治疗方案,并帮助了解儿童意外吞食磁珠造成的危害。
收集 72 例多发性胃肠道穿孔或梗阻患儿的资料。72 例儿科患者分为穿孔组和非穿孔组。分析资料包括性别、年龄、病史、居住地(农村或城市)、照顾者的教育背景、术中发现的异物位置和数量、术中是否确认穿孔,以及磁珠意外吞食次数。
超声术前诊断胃肠道穿孔的准确率为 71%,而直立腹部 X 线法的准确率仅为 46%。就症状而言,与无症状患儿相比,呕吐和腹痛伴呕吐及腹胀的患儿穿孔的风险分别增加了 13.844 倍和 12.703 倍。穿孔组和非穿孔组在年龄、性别、病史和吞食磁珠数量方面无统计学差异(P>0.05);然而,在白细胞计数(P=0.048)和 C 反应蛋白水平(P=0.033)方面有统计学差异。共有 56%的病例行剖腹探查术和穿孔修补术,19%的病例行胃镜检查和剖腹探查术。所有患儿术后均无并发症恢复良好。
怀疑儿童意外吞食磁珠后应尽快行腹部超声和/或直立腹部 X 线检查。大多数情况下需要立即进行手术干预。鉴于吞食此类异物的严重后果,必须告知家长和/或照顾者防止幼儿使用此类产品的重要性。