TAMER SEKMENLİ, İLHAN ÇİFTCİ, Murat ÖNCEL, GÜVEN SADİ SUNAM

Çocuklarda özofagus yabancı cisimleri

Selçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagus'a yabancı cisim tanısıyla yatmış ve tedavi olmuş olguların retrospektif değerlendirilmesi amaçlandı. Gereç ve yöntem: Selçuk Üniversitesi Tıp Fakültesi Çocuk Cerrahisi ve Göğüs Cerrahisi Kliniklerince Ocak 2013 ile Ocak 2014 tarihleri arasında çocuk hastalarda özofagusda yabancı cisim tanısıyla yatmış ve tedavi olmuş olgular retrospektif değerlendirildi. Bulgular: Hastanemizde son 1 yıl içinde toplam 13 hasta, endoskopik olarak özofagusda yabancı cisim nedeniyle tedavi edildi. Ortalama yaş 4.8 yaş (6ay-12yaş) idi. Birinci darlıkda yabancı cisim 10 hastada olup 6'sında (%60) bulunan cisim paraydı. 2. darlık'da 2 olguda bu gıda artığı olup, bu iki olgunun birinde opere özofagus atrezi darlığı nedeniyle gıda artığı vardı, diğerinde ise koraziv madde içimi sonrası oluşan darlığa sekonder gıda artığı vardı. Sonuç: Özofagus yabancı cisimlerinin erken tanısı, tedavisi ciddi ve hayatı tehdit edebilecek komplikasyonlardan dolayı çok önemlidir. Yabancı cisimlerden para en sık görülümekte olup, özofagustaki yabancı cisim disk pil ise, erken dönemde çıkarılmalıdır. Çünkü ciddi yanık ve perforasyon yapabilir

Esophageal foreign bodies in children

The medical records of all hospitalized and treated patients diagnosed with foreign body in the esophagous between January 2013 and January 2014 in Department of Pediatric Surgery and Thorasic Surgery in Selcuk University Medical Faculty were evaluated retrospectively. Material and methods: The files of these patients were evaluated in terms of age, sex, type of foreign body, foreign body localization, treatment, symptoms, and complications. Results: Thirteen patients were treated endoscopically in our hospital during the last year for foreign bodies in the esophageal web. The average age of the patients was 4.8 years (6 months-12 years). Foreign body was located in the 1st narrow section in 10 patients and in 6 (60%) it was coin. In two cases, in the 2nd narrow section residual food was the foreign body in the esophageal web. Out of these two cases, residual food was in the 2nd narrow section due to operated esophageal atresia. In the other one, due to swallowing of corrosive material secondary residual food was in the 2nd narrow section. There were only 2 patients, aged 5 years and more, with foreign body in was in the 2nd narrow section. Conclusion: Early diagnosis of foreign bodies in the esophageal web is of almost importance due to the possibility of serious and life-threatening complications. Among the foreign bodies, coin was the most evident one. If the foreign body in the esophageal web is a disc battery, it should be removed at an early stage as it may lead to severe burns and perforation

___

Yalçınkaya İ, Er M. Trakeobronş ve Öön Tıp Derg 1998;5:31-4.
Macpherson RI, Hill JG, Othersen HB, et al. Esophageal foreign bodies in children: Diagnosis, treatment and complications. AJR 1996;166:919-24.
Kim SS, Kim JI, Kim SW, et al. Management of foreign bodies in the gastrointestinal tract: an analysis of 104 cases in children. En- doscopy 1999;31:302-4.
Wyllie R. Foreign bodies in the gastrointestinal tract. Curr Opin Pediatr 2006;18:563.
Banerjee R, Rao GV, Sriram PV, et al. Button battery ingestion. Indian J Pediatr 2005;72:173.
Craig RM; Vanagunas AD: Foreign bodies in the esophagus. İn: Shields TW (ed): General Thoracic Surgery. Lippincott Williams & Wilkins, Philadelphia, 5th ed. 2000;1763-7.
Uyemura MC. Foreign body ingestion in children. Am Fam Phy- sician 2005;72:287.
Denney W, Ahmad N, Dillard B, Nowicki MJ. Children will eat the strangest things: a 10-year retrospective analysis of foreign body and caustic ingestions from a single academic center. Pediatr Emerg Care 2012;28:731.
Ngan JH, Fok PJ, Lai EC, et al. A prospective study on fish bone ingestion. Experience of 358 patients. Ann Surg 1990;211:459.
Yalçin S, Karnak I, Ciftci AO, et al. Foreign body ingestion in children: an analysis of pediatric surgical practice. Pediatr Surg Int 2007;23:755.
Webb WA. Management of foreign bodies of the upper gastroin- testinal tract: update. Gastrointest Endosc 1995;41:39.
Macmanus JE. Perforation of the intestine by ingested foreign bo- dies. JAMA 1941;53:393.
Benjamin SB. Small bowel obstruction and the Garren-Edwar- ds gastric bubble: an iatrogenic bezoar. Gastrointest Endosc 1988;34:463.
Başer M, Arslantürk H, Kisli E, et al. Primary aortoduodenal fistu- la due to a swallowed sewing needle: a rare cause of gastrointesti- nal bleeding. Ulus Travma Acil Cerrahi Derg 2007;13:154.
Seikel K, Primm PA, Elizondo BJ, Remley KL. Handheld metal de- tector localization of ingested metallic foreign bodies: accurate in any hands? Arch Pediatr Adolesc Med 1999;153:853.
Wyllie R. Foreign bodies in the gastrointestinal tract. Curr Opin Pediatr 2006;18:563.
Gmeiner D, von Rahden BH, Meco C, et al. Flexible versus rigid endoscopy for treatment of foreign body impaction in the esopha- gus. Surg Endosc 2007;21:2026.
Waltzman M. Management of esophageal coins. Pediatr Emerg Care 2006;22:367.
Sharieff GQ, Brousseau TJ, Bradshaw JA, Shad JA. Acute esop- hageal coin ingestions: is immediate removal necessary? Pediatr Radiol 2003;33:859.
Votteler TP, Nash JC, Rutledge JC. The hazard of ingested alkaline disk batteries in children. JAMA 1983;249:2504.