Çocuklarda yabancı cisimlerin kazara yutulması: tek merkezli yapılan çalışma.

Year 2021, , 417 - 419, 15.12.2021

Mehmet Uysal

https://doi.org/10.54005/geneltip.975274

Abstract

Amaç: Çocukluk çağında sindirim sistemine ağız yoluyla kazara alınan yabancı cisimler önemli bir sağlık sorunudur. Çalışmamızda, tek merkezde kazara yabancı cisim yutma nedeni ile başvuran çocukları retrospektif olarak değerlendirip, karşılaşılan vakalarda durumu yönetme deneyimini göstermeyi amaçladık.
Hastalar ve Yöntem: Karaman Eğitim ve Araştırma Hastanesi Çocuk Cerrahisi Kliniği’nce Mart 2016 ile Şubat 2021 tarihleri arasında yabancı cisim yutma nedeni ile hastalar yaş, cinsiyet, yabancı cismin cinsi, lokalizasyonu, radyolojik, ve klinik bulgular ile uygulanan tedavi açısından retrospektif olarak değerlendirildi. Hastaların parametreleri bilgisayar veri tabanından alındı. Eksik verilere sahip hastalar çalışma dışında tutuldu.
Bulgular: Hastanemizde çalışma kriterlerine uygun kazara yabancı cisim yuttuğu tespit edilen 72 olgu incelendi. Eksik veriler nedeniyle biri dışlandı. Hastaların yaşları 6 ay ile 14 yaş arasında değişmekte olup 37 (% 51,4)’si 3 yaş ve altındadır.
En sık yutulan yabancı cisim madeni paradır 35/72 (% 48,6), onu kalem pil 11/72 (%15,3), mıknatıs 6/72 (%8.3%) ve disk şeklinde pil 5/72 (% 7), 3 (%4.2) kırık cam, 3(%4.2) bilye, 2 (%2.8) kürdan,2 (%2.8) oyuncak parçası olduğu düşünülen plastik, 2 (%2.8) toplu iğne, 2(%2.8) vida, 1(%1.4) saç tokası izlemektedir. Sadece 10 (%13.9) hastada yutulan materyal radyografide görülmeyen radyolüsentti. Bunların büyük çoğunluğu 57/72(%79,1) gastrointestinal sistem ile dışarı atıldı. Kaza ile yutulan yabancı cisimlerden geriye kalan 9 (%12.5)’u Magill forseps,6(%8.3)’sı endoskopik olarak alındı. Hiçbir hasta eksploratif laparotomiye ihtiyacı olmadı.
Sonuç: Madeni paranın yanlışlıkla yutulması, çocuklarda hala en yaygın yabancı cisimlerdir. Elektronik bir cihazda yaygın olarak kullanılan düğme pil giderek yaygınlaşmaktadır. Yabancı cisimlerin çoğu radyografi ile görselleştirilebilir ve vakaların çoğunda materyal herhangi bir müdahale olmaksızın kendiliğinden dışarı atılır. Hastaların erken teşhisi ve tedavisi, olası komplikasyon riskini azaltmak için önemlidir.

Keywords

: Çocuklar, kaza sonucu, magill forseps, endoskopi

Accidental ingestion of foreign bodies in children: a single center study.

Abstract

Objective: Accidental oral ingestion of foreign bodies into the digestive system in childhood is an important health problem. Our study aimed to retrospectively evaluate children admitted to a single center due to accidental ingestion of foreign bodies and to show the experience of managing the situation in the cases encountered. Our study aimed to retrospectively evaluate children admitted to a single-cent due to accidental ingestion of foreign bodies and to show the experience of managing the situation in the cases encountered.
Patients and Methods: The patients were evaluated retrospectively in terms of age, gender, type of foreign body, localization, radiological and clinical findings, and treatment applied by the Pediatric Surgery Clinic of Karaman Training and Research Hospital between March 2016 and February 2021. The parameters of the patients were taken from the computer database. Patients with incomplete data were excluded.
Results: 72 patients found to have accidentally ingested foreign bodies following the study criteria in our hospital were examined. One was excluded due to missing data. The ages of the patients ranged from 6 months to 14 years, and 37/72 (51.4%) were younger than 3 years.
The most commonly ingested objects were coins 35/72 (48.6%), followed by a pencil battery 11/72 (15.3%), a magnet 6/72( 8.3%), and a disk-shaped battery 5/72 (7%), 3 (4.2%) shattered glass, 3 (4.2%) marbles, 2 (2.8%) toothpicks, 2 (2.8%) unidentified plastic objects (toy parts), 2 (2.8%) needles, 2(2.8%) screws, 1 (1.4%) hairpin. In only 10 (13.9%) patients, the ingested material was radiolucent and was not seen on radiography. The majority of the ingested material 57/72 (79.1%) was spontaneously excreted through the gastrointestinal system. The remaining 9/72 (12.5%) of the foreign bodies that were ingested by accident were Magill forceps and 6/72 (8.3%) materials were taken endoscopically. None of the patients needed explorative laparotomy.
Conclusion: Accidental ingestion of coins is still the most common foreign body in children. The button battery, which is widely used in an electronic device, is increasingly common. Most foreign bodies can be visualized by radiography and in most cases, the material is expelled spontaneously without any intervention. Early diagnosis and treatment of patients are important to reduce the risk of possible complications.

Keywords

Children, accidental, magill forceps, endoscopy

References

• Referans 1. Thomson M, Andrea T, Jean-Marc D, et al. "Pediatric Gastrointestinal Endoscopy: European Society for Pediatric Gastroenterology Hepatology and Nutrition and European Society of Gastrointestinal Endoscopy Guidelines." J Pediatr Gastroenterol Nutr 2017; 64 : 133-153.
• Referans 2. Louie MC, Bradin S “Foreign body ingestion and aspiration,” Pediatrics in Review, 2009;30 (8), p. 295–301.
• Referans 3. Adhikari P, Shrestha BL, Baskota DK, Sinha, BK. “Accidental foreign body ingestion: analysis of 163 cases.” International Archives of Otorhinolaryngology, 2007; 11(3), p.267–270.
• Referans 4. Susy Safe Working Group, “The Susy Safe project overview after the first four years of activity,” International Journal of Pediatric Otorhinolaryngology, 2013;76(1): p. 3–11.
• Referans 5. Smaranda D, Nicoleta G, Ioan S, et al. “Foreign bodies ingestion in children: Experience of 61 cases in Pediatric Gastroenterology Unit from Romania, Hindawi Publishing Corporation Gastroenterology Research and Practice, 2016;2016:1982567
• Referans 6. Allan BW, Robert C, Gregory WH, et al. "Harwood-Nuss' Clinical Practice of Emergency Medicine, 2014;6(1):1860.
• Referans 7. Ulaşsaz E, Arıkan Ç, Özgenç F, Duyu M,Ozananlar Y. The utility of handheld metal detectors in confirming metallic foreign body ingestion in the pediatric emergency department. Turk J Gastroenterol. 2010;21(2):135-139.
• Referans 8. Hazwan BH, Vigil J, Suraj M, Sashikuar G. "Handheld Metal Detector for Metallic Foreign Body Ingestion In Pediatric Emergency’’ The Indian j of Pediatrics. 2018;85(8): 618-624.
• Referans 9. Anna N, Martyn Harvey, Grant C, "Accuracy of Bedside Ultrasound for the Detection of Soft Tissue Foreign Bodies by Emergency Doctors." Emerg Med Australasia 2010;22(1): 30-34.
• Referans 10.Guelfguat M, Kaplinsky V, Reddy SH, DiPoce J. Clinical Guidelines for Imaging and Reporting Ingested Foreign Bodies.AJR 2014; 203:37–53
• Referans 11. Başpinar I, Şahin S, Erdoğan G. Yabancı cisim yutma sonucu gelişen akut mekanik bağırsak tıkanıklığı: Olgu sunumu.Ulus Travma Acil Cerrahi Derg 2010;16 (1):92-94.
• Referans 12. Denney W, Ahmad N, Dillard B, Nowicki MJ. Children will eat the strangest things: a 10-year retrospective analysis of the foreign body and caustic ingestions from a single academic center. Pediatr Emerg Care 2012;28(8):731–734.
• Referans 13. Bronstein AC, Spyker DA, Cantilena LR Jr, Rumack BH, Dart RC. 2011 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 29th annual report. Clin Toxicol (Phila) 2012;50(10):911–1164.