小児消化管異物216例の検討 FOREIGN BODIES IN THE GASTROINTESTINAL TRACT IN CHILDREN : A REVIEW OF 216 CASES

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著者

    • 大津 一弘 OHTSU Kazuhiro
    • 県立広島病院母子総合医療センター小児外科 Department of Pediatric Surgery, Hiroshima Prefectural Hospital
    • 古田 靖彦 FURUTA Yasuhiko
    • 県立広島病院母子総合医療センター小児外科 Department of Pediatric Surgery, Hiroshima Prefectural Hospital
    • 塩田 仁彦 SHIOTA Masahiko
    • 県立広島病院母子総合医療センター小児外科 Department of Pediatric Surgery, Hiroshima Prefectural Hospital

抄録

われわれの経験した小児消化管異物216例について検討した.基本方針としては食道異物は速やかに食道より摘出,胃より肛側の異物は経過観察が原則であるがボタン電池はマグネットカテーテルで,鋭利な異物は内視鏡で摘出する.手術適応は穿孔やイレウスである.自然排出に要する時間は2週間以内に約90%が排出される.異物の大きさと自然排出との関連は明らかではなかった.消化管異物摘出法は内視鏡,マグネットカテーテル,バルーンカテーテルによるがマグネットカテーテルのみでは摘出不可能な症例に対してはバルーンカテーテルの併用が有効であった.手術症例は4例であり2例は開いた安全ピン, 2例は胃石である. 2例の食道異物による縦隔炎は保存的に治療可能であった.臨床家に求められる消化管異物の診断,治療の原則について言及した.

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.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 61(7), 1698-1703, 2000-07-25

    Japan Surgical Association

参考文献:  11件中 1-11件 を表示

被引用文献:  7件中 1-7件 を表示

キーワード

各種コード

  • NII論文ID(NAID)
    10008502396
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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