Bonadio W A, Emslander H, Milner D, Johnson L
Children's Hospital of St. Paul, Minnesota.
Pediatr Emerg Care. 1994 Dec;10(6):333-4. doi: 10.1097/00006565-199412000-00007.
An important factor in choosing the method to remove an ingested coin lodged in the esophagus (endoscopy with forceps extraction, Foley catheter extraction, or bougienage advancement) is the duration of the ingestion and the risk for compromise to the esophageal mucosal integrity. We reviewed 50 consecutive cases occurring during a five-year period of children with a witnessed acutely ingested coin (less than 24 hours duration) that was lodged in the esophagus to determine the degree of compromise of the esophageal mucosal integrity. All coins were removed by endoscopic forceps extraction, with direct inspection of esophageal mucosa. The duration of ingestion was less than eight hours in 22 patients, nine to 16 hours in 16 patients, and 17 to 24 hours in 12 patients. Endoscopy showed that the esophageal mucosa had no abnormalities in 42 patients, "minimal erythema" in six patients, and "minimal abrasion" in two patients. There were no symptoms or complications referable to the gastrointestinal tract reported subsequent to coin removal in any case. Ingested coins that are lodged in the esophagus for fewer than 24 hours do not cause significant compromise to the integrity of the esophageal mucosa. We discuss the implications of these findings in the context of choosing an appropriate method for removing esophageal coins.
选择取出卡在食管内的误吞硬币的方法（用钳子经内镜取出、用 Foley 导管取出或探条推进法）时的一个重要因素是误吞时间以及食管黏膜完整性受损的风险。我们回顾了连续 50 例在五年期间发生的儿童病例，这些儿童误吞硬币且被目睹（误吞时间少于 24 小时），硬币卡在食管内，以确定食管黏膜完整性受损的程度。所有硬币均通过内镜用钳子取出，并直接检查食管黏膜。22 例患者误吞时间少于 8 小时，16 例患者误吞时间为 9 至 16 小时，12 例患者误吞时间为 17 至 24 小时。内镜检查显示，42 例患者食管黏膜无异常，6 例患者有“轻度红斑”，2 例患者有“轻度擦伤”。在任何病例中，取出硬币后均未报告有与胃肠道相关的症状或并发症。误吞的硬币卡在食管内少于 24 小时不会对食管黏膜的完整性造成显著损害。我们在选择取出食管内硬币的合适方法的背景下讨论了这些发现的意义。
