Williams James, Pumiglia Luke, Zhang Bobby, Francis Andrew, Prey Beau, Ciullo Sean, Horton John, Barlow Meade
Department of General Surgery, Madigan Army Medical Center, Tacoma, Washington.
Department of General Surgery, Madigan Army Medical Center, Tacoma, Washington.
J Surg Res. 2024 Dec;304:273-279. doi: 10.1016/j.jss.2024.10.036. Epub 2024 Nov 21.
Foreign body ingestion is a common occurrence in the pediatric population. Superabsorbent polymers (i.e., water beads [WB]), such as Orbeez, are brightly colored spheres, can expand up to 100x their original size and are marketed as toys for kids. Ingested WB may lead to a bowel obstruction and typically require surgical removal.
Fully expanded WBs (N = 15) were placed into 1 of the 3 solutions: water (N = 5), gastrografin (N = 5), or 1:1 mixture of gg and water (N = 5), with serial diameter measurements obtained at 1, 4, 8, and 24 h. Additionally, fully expanded WBs were placed into succus containing post mortem porcine small bowel and mixed with gastrografin (N = 10) or nothing (N = 10), with diameters measured prior to placement and at 4 h.
At all time points, the mean WB diameter of the gastrografin arm was significantly smaller than the other two arms (P < 0.01). WBs submerged in gastrografin saw a 58% reduction in diameter at 4 h compared to 45% reduction in the 1:1 mixture and a 2% growth in water (P < 0.01). When placed into small bowel containing gastrografin, the mean WB diameter decreased by 47% at 4 h versus 37% in the control arm (P < 0.01).
Gastrografin significantly reduced the size of WB in both the in-vitro and ex-vivo post mortem animal study; and it may offer a nonsurgical option for the management of water bead ingestion. Studies assessing the clinical efficacy of a gastrografin nonoperative management strategy are needed.
异物摄入在儿科人群中很常见。超吸水性聚合物（即水珠子[WB]），如奥比兹，是颜色鲜艳的球体，能膨胀至其原始大小的100倍，作为儿童玩具销售。摄入的水珠子可能导致肠梗阻，通常需要手术取出。
将完全膨胀的水珠子（N = 15）放入3种溶液中的一种：水（N = 5）、泛影葡胺（N = 5）或泛影葡胺与水的1:1混合物（N = 5），在1、4、8和24小时进行连续直径测量。此外，将完全膨胀的水珠子放入含有死后猪小肠的肠液中，并与泛影葡胺（N = 10）混合或不混合（N = 10），在放置前和4小时测量直径。
在所有时间点，泛影葡胺组的水珠子平均直径显著小于其他两组（P < 0.01）。与1:1混合物中45%的直径减小和水中2%的直径增长相比，浸泡在泛影葡胺中的水珠子在4小时时直径减小了58%（P < 0.01）。当放入含有泛影葡胺的小肠中时，4小时时水珠子的平均直径下降了47%，而对照组为37%（P < 0.01）。
在体外和死后动物离体研究中，泛影葡胺均显著减小了水珠子的大小；它可能为水珠子摄入的管理提供一种非手术选择。需要进行评估泛影葡胺非手术管理策略临床疗效的研究。
