小児消化管異物216例の検討

  • 大津 一弘
    県立広島病院母子総合医療センター小児外科
  • 古田 靖彦
    県立広島病院母子総合医療センター小児外科
  • 塩田 仁彦
    県立広島病院母子総合医療センター小児外科

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  • FOREIGN BODIES IN THE GASTROINTESTINAL TRACT IN CHILDREN-A REVIEW OF 216 CASES-

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Two-hundred and sixteen infants and children with foreign bodies being observed in the digestive tract have been experienced in our department for the last 34 years.<br> As our basic guidelines for treatment, esophageal foreign bodies are immediately removed from the esophagus, and foreign bodies from the stomach through the anus are observed as a rule, but button-shaped battery is removed by using a magnet catheter and dangerous sharp ones by endoscopy. Foley catheter is helpful, if magnetic catheter alone fails in removing. Operation in indicated for cases of perforation or intestinal obstruction. About 90% of observed foreign bodies are excreted spontaneously within 2 weeks. Relation between the size of foreign body and spontaneous excretion is obscure.<br> The coin was the most common foreign body, followed by button-shaped battery, nail, plastic, tack, and needle, which were swallowed by mistake. In 150 out of 216 cases, foreign bodies were excreted spontaneously, but four cases needed surgery. Two cases of an opened safety pin showed perforation in the stomach, and in the duodenum, respectively. Two cases of bezoar occupied the stomach cavity as alarge mass. Mediastinitis caused by foreign body in the esophagus in two cases were able to be conservatively treated.

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