Sarihan H, Kaklikkaya I, Ozcan F
Department of Pediatric Surgery, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey.
J Cardiovasc Surg (Torino). 1998 Aug;39(4):515-8.
Fifteen consecutive children with ingested safety pins were evaluated retrospectively. Eight patients were males and seven were girls. The mean age of the patients was 5.4 years ranging from 7 months to 16 years. Two of 15 patients were mentally retarded Seven safety pins ingestion were noted by parents, three older children applied with safety pin swallowing. Three infants referred with hypersalivation and swallowing difficulty. One of two mentally retarded patients had recurrent aspiration pneumonia, the other had neck abscess. These patients' lesions were detected incidentally by thoracic X-ray. Nine safety pins were at the level of the cricopharyngeus, one at the level of the aortic arch and five at the esophagogastric junction. A right esophagoscopy was used for extraction of safety pins under general anesthesia and endotracheal intubation were used. Before esophagoscopy control plain X-ray was obtained for location of safety pin. Nine safety pins were extracted by esophagoscopy. Three safety pins spontaneously and three during anesthesia induction passed through the esophagus falling down the stomach. Five of these six safety pins were spontaneously extracted without complication. However one open safety pin lodged at the duodenum and laparotomy was required. In this article, etiology and management of safety pin ingestion in children are discussed.
对15例连续摄入安全别针的儿童进行回顾性评估。8例为男性，7例为女性。患者的平均年龄为5.4岁，范围从7个月至16岁。15例患者中有2例智力发育迟缓。7例安全别针摄入是由家长发现的，3例年龄较大的儿童是主动吞入安全别针。3例婴儿因流涎过多和吞咽困难前来就诊。2例智力发育迟缓患者中，1例反复发生吸入性肺炎, 另1例有颈部脓肿。这些患者的病变是通过胸部X线偶然发现的。9枚安全别针位于环咽肌水平，1枚位于主动脉弓水平，5枚位于食管胃交界处。在全身麻醉和气管插管下，采用右侧食管镜取出安全别针。在食管镜检查前拍摄对照平片以确定安全别针的位置。9枚安全别针通过食管镜取出。3枚安全别针自行通过食管进入胃内，3枚在麻醉诱导期间进入胃内。这6枚安全别针中有5枚自行排出且无并发症。然而，1枚开口的安全别针卡在十二指肠，需要进行剖腹手术。本文讨论了儿童摄入安全别针的病因及处理方法。
