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儿童误食动力沙导致肠套叠和肠梗阻:一例报告

Ingestion of kinetic sand leading to intussusception and bowel obstruction in a child: a case report.

作者信息

Turner Acara, Sico Rita, Seifarth Federico G

机构信息

Division of Plastic, Reconstructive, and Hand Surgery, Department of General Surgery, West Virginia University School of Medicine, Morgantown, WV, USA.

Department of Radiology, West Virginia University School of Medicine, Morgantown, WV, USA.

出版信息

AME Case Rep. 2023 Nov 21;8:13. doi: 10.21037/acr-23-37. eCollection 2024.

Abstract

BACKGROUND

Kinetic sand is a type of play sand that is marketed to children above the age of three years old. It is comprised of sand coated with silicone oil, holding its shape when squeezed or pressed. It is described as a non-toxic, hypoallergenic, safe sand for arts and crafts, and is highly appealing due to its realistic appearance and odor. We present the first reported case of bowel obstruction due to small and large bowel intussusceptions caused by ingestion of kinetic sand leading to hospitalization for medical treatment in a young girl.

CASE DESCRIPTION

We present a two-year-old female patient with a past medical history of autism, trichotillomania, and pica who presented to our hospital as a transfer for two days of abdominal pain and non-bloody bilious emesis. Radiographic workup included abdominal ultrasound, abdominal X-ray, and computed tomography that revealed both small bowel intussusceptions and colo-colonic intussusception. Fluoroscopic gastrografin enema was performed and yielded free reflux of contrast into the distal ileum. The admitted patient continued to pass the sand with an eventual resolution of abdominal pain.

CONCLUSIONS

Intussusception is considered a medical emergency and should be treated as soon as possible before potentially fatal complications occur. This report serves to highlight the potential dangers of kinetic sand ingestion and provide guidance for the management of intussusception and bowel obstruction after kinetic sand ingestion in the pediatric population.

摘要

背景

动力沙是一种面向三岁以上儿童销售的玩沙产品。它由涂有硅油的沙子组成,在挤压或按压时能保持形状。它被描述为一种无毒、低过敏性、适合艺术和手工艺的安全沙子,因其逼真的外观和气味极具吸引力。我们报告了首例因摄入动力沙导致小肠和大肠套叠引起肠梗阻的病例,一名年轻女孩因此住院接受治疗。

病例描述

我们介绍了一名两岁女性患者,她有自闭症、拔毛癖和异食癖病史,因腹痛两天和非血性胆汁性呕吐被转诊至我院。影像学检查包括腹部超声、腹部X线和计算机断层扫描,结果显示小肠套叠和结肠-结肠套叠。进行了透视下硫酸钡灌肠,造影剂自由反流至回肠末端。入院患者持续排出沙子,腹痛最终缓解。

结论

套叠被视为医疗急症,应在可能出现致命并发症之前尽快治疗。本报告旨在强调摄入动力沙的潜在危险,并为儿科人群摄入动力沙后套叠和肠梗阻的管理提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f511/10789891/8c69e49322b2/acr-08-23-37-f1.jpg

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