Management of Foreign Body Ingestion in Children: Experience with 42 Cases

小兒消化道異物處理：42個案例

林茂才(Mao-Tsair Lin) ； 楊俊仁(Chun-Yan Yeung) ； 李宏昌(Hung-Chung Lee) ； 許錦城(Jin-Cherng Sheu) ； 王念陸(Neng-Lu Wang) ； 李國森(Kuo-Sheng Lee)

《Acta Paediatrica Taiwanica》 44卷5期 (2003/10) Pp. 269-273

https://doi.org/10.7097/APT.200310.0269

摘要

小兒消化道異物是常見的急診案例，雖然很少造成死亡，但可能含有一些後遺症，例如：消化道破裂或次發性的感染。我們收集了過去十年來的病例，並回顧文獻來進行探討。
從1991年12月到2001年12月，我們收集了42位住院病例，這些個案中大部份是被家屬親眼目睹或懷疑有異物吞食的情形，少部份是因其他症狀在住院過程中間接被診斷。處理包含了食道鏡及內視鏡的異物移除，開刀以及觀察等方式。
我們的研究結桔果發現消化道異物的好發年齡為五歲以下，吞入的異物以硬币为多“60％的病人含有腹痛、嘔吐等症狀。大部分的病例均能成功移除或自行排出異物，極少部份產生了消化道破裂的後遺症。
小兒消化道異物是常見的急診案例，對於不同種類及不同位置的異物，有不同的處理方式。父母應教導小孩避免異物吞入，同時也要提醒醫師在操作食道鏡或內視鏡時，小心可能的併發症。

關鍵字

消化道異物 ； 內視鏡

並列摘要

Ingestion of foreign bodies occurs frequently in children, but there are no definite management guidelines. We reviewed 42 pediatric cases of accidental ingestion of foreign bodies with or without symptoms during the past 10 years. In decreasing order of frequency, the foreign bodies included: coins, sharp objects (needle, pin), bones (fish and chicken bone), metal object, food, seeds, plastic material, magnets, jewelry ring, and others. The majority of children were 5 years old or younger. At the time of presentation, the vast majority of objects were located in the esophagus. Sixty percent of the patients had symptoms, such as abdominal pain, vomiting and cough. Management included observation, esophagoscopy, panendoscopy, and laparotomy. Four patients (9.5%) had complications. One patient who ingested a magnet suffered from esophageal perforation with mediastinitis. Two had deep neck abscess due to esophageal penetration by bones. Another patient had hemorrhagic gastritis after swallowing a coin. All patients discharged after treatment, and none died.

並列關鍵字

foreign body ； endoscopy