在资源有限的环境中通过内镜检查处理的异物摄入延迟呈现:病例报告及文献综述

Delayed presentation of foreign body ingestion in resource-limited setting managed with endoscopy: Case report and literature review.

作者信息

Asmare Wudassie Melak, Ayen Addisu Assfaw, Lashitie Zelalem Mulu, Endalew Ageru Zeleke, Teshome Bekalu Gashaw, Bezie Gebeyaw Addis

机构信息

Department of Internal Medicine, Gastroenterology and Hepatology Unit, Bahir Dar University, Bahir Dar, Ethiopia.

Department of Internal Medicine, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

Int J Surg Case Rep. 2025 Jul 5;133:111620. doi: 10.1016/j.ijscr.2025.111620.

Abstract

INTRODUCTION AND IMPORTANCE

Foreign body (FB) ingestion is a common pediatric gastrointestinal emergency, frequently involving coins, batteries, and magnets in children aged 6 months to 5 years, with boys affected more often. The 2021 poison control data reports ∼55,000 cases annually in children <5.

CASE PRESENTATION

A 4-year-old girl presented to the pediatric emergency unit four months after ingesting a one Ethiopian birr coin. One week prior to her hospital presentation, she developed a dry cough, stridor, tachypnea, nausea, vomiting, and dysphagia. Evaluation revealed tachypnea, tachycardia, and oxygen desaturation to 87 % on room air. A chest X-ray showed a radio-opaque, circular foreign body at the T2-T3 level. The foreign body was successfully removed endoscopically, and the patient's condition improved after the procedure.

CASE DISCUSSION

Foreign body ingestion is a frequent concern in pediatrics. The risk is elevated in children with congenital or acquired neuromuscular disorders and those with psychosocial risk factors. Clinical presentation varies, with most cases presenting acutely with respiratory or gastrointestinal symptoms, but delayed presentations can also occur. Effective management, including appropriate evaluation, endoscopic removal, and prevention strategies, is essential for optimizing patient outcomes.

CONCLUSION

Foreign body ingestion, while typically presenting acutely, can have delayed presentations, especially in resource-limited settings, potentially leading to complications. Endoscopic management is often successful, underscoring the importance of considering foreign body ingestion in the differential diagnosis, even in cases with a long or unclear history, to ensure optimal patient outcomes.

摘要

引言与重要性

异物吞食是常见的儿科胃肠道急症,6个月至5岁儿童中常涉及硬币、电池和磁铁,男孩受影响更为常见。2021年毒物控制数据报告显示,每年<5岁儿童中有约55000例病例。

病例介绍

一名4岁女孩在吞食一枚埃塞俄比亚比尔硬币四个月后就诊于儿科急诊室。在她入院前一周,出现干咳、喘鸣、呼吸急促、恶心、呕吐和吞咽困难。评估发现呼吸急促、心动过速,在室内空气中氧饱和度降至87%。胸部X线显示在T2 - T3水平有一个不透射线的圆形异物。该异物通过内镜成功取出,术后患者病情好转。

病例讨论

异物吞食是儿科常见问题。先天性或后天性神经肌肉疾病患儿以及有社会心理风险因素的患儿风险更高。临床表现各异,大多数病例急性出现呼吸或胃肠道症状,但也可能出现延迟表现。有效的管理,包括适当评估、内镜取出和预防策略,对于优化患者预后至关重要。

结论

异物吞食虽然通常急性出现,但也可能有延迟表现,特别是在资源有限的环境中,可能导致并发症。内镜管理通常成功,这突出了在鉴别诊断中考虑异物吞食的重要性,即使在病史较长或不明确的病例中,以确保患者获得最佳预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89ca/12275488/fa3f70be29c1/gr1.jpg

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