Flexible endoscopic procedure in children with foreign bodies in their upper gastrointestinal system

Yıl 2014, , 205 - 209, 01.03.2014

Kaan Demirören Ahmet Cumhur Dülger Şehmus Ölmez Veli Avcı Salim Bilici Mehmet Melek Halit Pulat

https://doi.org/10.5798/diclemedj.0921.2014.01.0400

Cited By: 1

Öz

Objective: Foreign body ingestion is an important public health problem. We pointed to this subject and aimed to determine the effectiveness of flexible endoscopic procedure in this study. Methods: We evaluated retrospectively fifty children having foreign body in their upper gastrointestinal system, who underwent flexible endoscopic procedure. Results: Of the patients, mean age was 5.5 ± 4 years old (range: 0.5-16 years), 64% was female. Ingested foreign bodies were coin (58%), pin (10%), battery (6%), nail (6%), necklace (6%), safety pin (4%) and sewing pin, wire hairclip, ring, button and chicken skin. In endoscopic procedure, foreign bodies were seen in upper esophagus (32%), middle esophagus (26%), lower esophagus (8%), stomach (18%), bulbus (4%) and second part of duodenum (8%), but were not seen in 4% of the cases. While 94% of foreign bodies were endoscopically removed, 6% of them were pushed to stomach with gastroscope from esophagus and left for spontaneous passage. Any important complication was developed. Conclusion: Flexible endoscopic procedure is an effective and safe method for removal of gastrointestinal system foreign bodies in children.

Anahtar Kelimeler

Flexible endoscopy, gastrointestinal system, foreign body, children

Flexible endoscopic procedure in children with foreign bodies in their upper gastrointestinal system

Öz

Amaç: Çocuklarda ağız yoluyla alınan yabancı cisimler bir halk sağlığı problemi haline gelmiştir. Mevcut çalışmada bu konuya dikkat çekmek ve fleksibl endoskopik yöntemin etkinliğini göstermek amaçlandı. Yöntemler: Çalışmamızda fleksibl endoskopla çıkarma işlemi uyguladığımız, üst gastrointestinal sistemlerinde yabancı cisimleri olan 50 çocuk olguyu retrospektif olarak inceledik. Bulgular: Olguların ortalama yaşı 5,5 ± 4 yıl (yaş aralığı: 0,5-16 yıl) olup %64\'ü kız idi. Yutulan cisimlerin %58\'i madeni para, %10\'u toplu iğne, %6\'sı pil, %6\'sı çivi, %6\'sı kolye, %4\'ü çengelli iğne ve kalanı da dikiş iğnesi, tel toka, alyans, düğme ve tavuk derisi idi. Cisimlerin %32\'si üst özofagusta, %26\'sı orta özofagusta, %8\'i alt özofagusta, %18\'i midede, %4\'ü bulbusta ve %8\'i duodenum ikinci kısmındaydı. %4 olguda ise endoskopik işlem esnasında yabancı cisim görülmedi. Üç yabancı cisim (%6) özofagustan mideye ittirilerek spontan çıkışa bırakıldı. Kalan %94 cisim ise endoskopla çıkarıldı. Hastalarda önemli bir komplikasyon gelişmedi. Sonuç: Fleksibl endoskop çocuklarda gastrointestinal yabancı cisimleri çıkarmada etkili ve güvenli bir yöntemdir.

Anahtar Kelimeler

Çocuk, fleksibl endoskop, gastrointestinal sistem, yabancı cisim

Kaynakça

• Wright CC, Closson FT. Updates in pediatric gastrointestinal foreign bodies. Pediatr Clin North Am 2013;60:1221-1239.
• Uyemura MC. Foreign body ingestion in children. Am Fam Physician 2005;72:287-291.
• Gregori D, Scarinzi C, Morra B, et al; ESFBI Study Group. Ingested foreign bodies causing complications and requir- ing hospitalization in European children: results from the ESFBI study. Pediatr Int 2010;52:26-32.
• Fox VL. Gastrointestinal Endoscopy. In: Walker WA, Goulet O, Kleinman RE, Sherman PM, Shneider BL, Sanderson IR, eds. Pediatric Gastrointestinal Disease. 4th edn. Ontario: BC Decker, 2004:1691-1692.
• Sandoval JA. Pediatric Gastrointestinal Foreign Bodies. Updated: May 11, 2011 http://emedicine.medscape.com/ article/933015-overview#showall
• Antoniou D, Christopoulos-Geroulanos G. Management of foreign body ingestion and food bolus impaction in chil- dren: a retrospective analysis of 675 cases. Turk J Pediatr 2011;53:381-387.
• Kay M, Wyllie R. Pediatric foreign bodies and their manage- ment. Curr Gastroenterol Rep 2005;7:212-218.
• İnci İ, Özçelik C, Ülkü R, Eren N. Özofagus Yabancı Cisim- leri: 682 Olgunun İncelenmesi. GKDC Dergisi 1999;7:148- 152.
• Alpay HC, Kaygusuz İ, Karlıdağ T, et al. Özefagus Yabancı Cisimleri. Fırat Tıp Dergisi 2008;13:247-250.
• Sayır F. Özofagus Yabancı Cisimleri: 329 Olgunun Analizi. The Eurasian Journal of Medicine 2007;39:112-114.
• Çobanoğlu U, Can M. 0-7 Yaş Dönemi Çocuklarda Özo- fagus Yabancı Cisimleri. Van Tıp Dergisi 2008;15:51-57.
• Köseoğlu B, Bakan V, Bilici S, et al. Çocukluk Çağı Gast- rointestinal Yabancı Cisimlerinin Tedavisi. Van Tıp Dergisi 2001;8:47-53.
• Katsinelos P, Kountouras J, Paroutoglou G, et al. Endoscop- ic techniques and management of foreign body ingestion and food bolus impaction in the upper gastrointestinal tract: a retrospective analysis of 139 cases. J Clin Gastroenterol 2006;40:784-789.
• Tokar B, Cevik AA, Ilhan H. Ingested gastrointestinal for- eign bodies: predisposing factors for complications in chil- dren having surgical or endoscopic removal. Pediatr Surg Int 2007;23:135-139.
• Morgenthal CB, Richards WO, Dunkin BJ, et al. The role of the surgeon in the evolution of flexible endoscopy. Surg Endosc 2007;21:838-853.
• Zhang S, Cui Y, Gong X, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract in South China: a retrospective study of 561 cases. Dig Dis Sci 2010;55:1305-1312.
• Smith MT, Wong RK. Foreign bodies. Gastrointest Endosc Clin N Am 2007;17:361-382.
• Lee JH, Lee JS, Kim MJ, Choe YH. Initial location de- termines spontaneous passage of foreign bodies from the gastrointestinal tract in children. Pediatr Emerg Care 2011;27:284-289.
• Opasanon S, Akaraviputh T, Methasate A, et al. Endoscopic management of foreign body in the upper gastrointestinal tract: a tertiary care center experience. J Med Assoc Thai 2009;92:17-21.
• Gershman G, Ament M. Practical Pediatric Gastrointes- tinal Endoscopy. Massachusetts: Blackwell Publishing, 2007:105-109.