Gastrointestinal Yabancı Cisim Olgularının incelenmesi

Amaç- giriş. Gastrointestinal yabancı cisimler tüm dünyada ciddi morbidite ve mortaliteye yol açabilen acil ve adli tıp pratiğinde sıkça karşılaşılan durumlardır. Bu çalışmada 18 yaş altı gastrointestinal sisteme kaçan yabancı cisim olgularını incelemeyi amaçladık. Yöntem. Adıyaman Üniversitesi Eğitim ve Araştırma Hastanesi Radyoloji Kliniğine 15.01.2013 ile 15.01.2019 tarihleri arasında radyolojik tetkikleri (Direk grafi, BilgisayarlıTomografi ve Manyetik rezonans görüntüleme) geriye dönük olarak incelendi. Çalışmaya dahil edilen 18 yaş altı olgular dört grupta incelemeye alındı. 1. Grupta 0-4 yaş, 2. Grupta 5-9 yaş, 3. Grupta 10-14 yaş ve 4. Grupta 15-18 olarak belirlendi. Yaş grupları arasında fark olup olmadığı, hangi yaş gruplarında sindirim sistemine en sık kaçan yabancı cisim türünün ne olduğu araştırıldı. Ayrıca olgular; yaş, cinsiyet, anatomik lokalizasyon ve yutulan yabancı cisim türüne göre incelendi. Yabancı cisimlerin niteliği;gıda içerikli, metal, plastik cisim vs. gözden geçirildi. Olgular radyolojik bulgular eşliğinde adli tıp ve adli radyoloji açısından değerlendirildi. Bulgular: Çalışma kriterlerine uygun olduğu tespit edilen (0-18 yaş) 191 olgu incelendi. Olgulardan 112’sinin(58,64) erkek ve 79 olgunun (41,36) ise kadın olduğu, yaş ortalamasının 10,3± 5,72 olduğu belirlendi. En sık gastrointestinal sisteme kaçan yabancı cismin 159 (83,25) olgu ile metalik yabancı cisimler olduğu belirlendi. Metalik cisimlerden metal paralar 78 (49,05) olgu ile ilk sırada yer aldığı tespit edildi. Yaş grupları açısından en sık 0-4 yaş grubundaki olgularda sindirim sistemine yabancı cismin kaçtığı belirlendi. Sonuç: Sindirim sistemine kaçan yabancı cisimler acil tanı ve tedavi gerektiren durumlar arasında yer almaktadır. Tanının doğrulanması için uygun radyolojik görüntüleme yöntemleri kullanılmalıdır. Özellikle risk grubundaki 0-4 yaş grubunda daha dikkatli olunması ile sindirim sistemine kaçan yabancı cisim olgularının azaltılabileceği kanaatindeyiz.

Anahtar Kelimeler:

Yabancı cisim yutma, Bilgisayarlı tomografi, yabancı cisimler, adli tıp

Evaluation of Gastrointestinal Foreign Body Cases

Aim: Gastrointestinal foreign bodies are frequently encountered in emergency and forensic medicine practice which can lead to serious morbidity and mortality worldwide. In this study, we aimed to investigate cases of foreign bodies ingestion to the gastrointestinal tract under the age of 18 years. Method: The radiological imaging (direct radiography, computed tomography and magnetic resonance imaging) of Adiyaman University Training and Research Hospital Radiology Clinic between 15.01.2013 and 15.01.2019 were retrospectively analyzed. Patients under 18 years of age were included in the study. Group 1 was 0-4 years, Group 2 was 5-9 years, Group 3 was 10-14 years and Group 4 was 15-18 years. The difference between the age groups and the age group in which the most frequently escaping to the digestive system was investigated what type of foreign body. Cases were ingested age, sex, anatomic localization and foreign body types; such as food, metal, plastic, etc. The cases were evaluated in terms of forensic medicine and forensic radiology with the help of radiological findings.Results: 191 patients (0-18 years) who were found to comply with the study criteria were evaluated. Of 79 (%41.36) cases were male and 12 (%58.64) female. It was determined that the mean age was 10.3 ± 5.72. The most common foreign body that determined in the gastrointestinal tract was metallic foreign bodies with 159 (%83.25) cases. It was determined that most frequently with 78 (%49,05) cases metal coin in gastrointestinal system. In the distribution according to age groups, the most frequently foreign body in digestive system was found 0-4 age group.Conclusion: Foreign bodies escaping to the digestive system are among the conditions requiring immediate diagnosis and treatment. Appropriate radiological imaging methods should be used to confirm the diagnosis. Especially, we considered that being more careful in the risk group, 0-4 age group, will reduce foreign body ingestion cases.

Keywords:

Foreign body ingestion, tomography, foreign bodies, forensic medicine,

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