Fatma ÖZCAN SIKI, Mehmet SARIKAYA, Metin GÜNDÜZ, Tamer SEKMENLİ, İlhan ÇİFTCİ

Pediatrik Hastalarda Manyetik Yabancı Cisim Yutulmasının Tek Merkezli Deneyimi

AMAÇ: Yabancı cisim (FB) yutulması çocuklarda yaygın bir kazadır. Son yıllarda, manyetik yabancı cisimlerden oyuncak üretimine bağlı olarak manyetik yabancı cisim yutma ile başvuran hasta sayısı artmıştır. Bu çalışmada son yıllarda yapılan literatür çalışmaları ile birlikte çoklu manyetik YC alımı olan hastalarda tedavi algoritmasını araştırdık. Farklı çalışmaların tedavi algoritmasını değerlendirerek ortak sonucu paylaşmayı amaçladık. GEREÇ VE YÖNTEM: Ocak 2015-Aralık 2022 tarihleri arasında kliniğimizde manyetik yabancı cisim yutma nedeniyle tedavi edilen hastalar retrospektif olarak incelendi. Hastaların demografik verileri, FB yutma zamanı, başvuru zamanı, yutma sayısı, ameliyat notları ve hastanede kalış süreleri kaydedildi. BULGULAR: Yedi yıl içinde 13 hasta manyetik YC alımı nedeniyle tedavi edildi. Yedi erkek ve altı kadın hasta vardı. Ortalama yaş 5,3 ± 4,2 idi. Beş hasta tek bir manyetik YC yuttu, bunlardan biri endoskopi ile yemek borusundan, dördü ise spontan olarak gastrointestinal kanaldan çıkarıldı. Birden fazla manyetik FB alan sekiz hastadan üçünde, FB'nin gastrointestinal sistemden spontan olarak çıkarılması görüldü. İkisi acil olmak üzere beş hastada laparotomi ile YC çıkarıldı. SONUÇ: Tek bir manyetik cismin yutulması izole bir yabancı cisim gibi herhangi bir müdahaleye ihtiyaç duymadan mide-bağırsak sistemime herhangi bir zarar vermeden gerçekleşir. Birden fazla manyetik yabancı cisim yutan hastaların çoğunda sandviç basıya bağlı olarak iskemi, nekroz, perforasyon ve hatta boğulma görülebilir. Nadir durumlarda, çoklu manyetik YC alımında spontan gastrointestinal salınım mümkündür. Çoklu manyetik FB yutulması durumunda asemptomatik olan hastalar takip edilebilir. Zamanında ve doğru işlemler uygulanarak daha noninvaziv tedavi ile başarılı sonuçlar alınmaktadır.

Anahtar Kelimeler:

çocuk, buckyball, bağırsak delinmesi, manyetik yabancı cisim

Single Center Experience of Magnetic Foreign Object Swallowing in Pediatric Patients

BACKGRAUND: Foreign body (FB) ingestion is a common accident in children. In recent years, the number of patients presenting with magnetic foreign body ingestion has increased due to the production of toys from magnetic foreign bodies. In this study, we investigated the treatment algorithm in patients with multiple magnetic FB ingestion, together with the literature studies conducted in recent years. We aimed to share the common result by evaluating the treatment algorithm of different studies. MATERIALS AND METHODS: Patients treated for magnetic foreign body ingestion in our clinic between January 2015 and December 2022 were retrospectively analyzed. The demographic data of the patients, the time of swallowing FB, the time of admission, the number of times they swallowed, the surgical notes, and the length of hospital stay were recorded. RESULTS: In seven years, 13 patients were treated for magnetic FB ingestion. There were seven male and six female patients. The mean age was 5.3 ± 4.2 years. Five patients swallowed a single magnetic FB, one of them was removed from the esophagus by endoscopy, and four of them were spontaneously removed from the gastrointestinal tract. Three of the eight patients who ingested multiple magnetic FB had spontaneous gastrointestinal tract removal of the FB. FBs were removed by laparotomy in five patients, two of whom was emergency. CONCLUSION: Ingestion of a single magnetic object occurs without the need for intervention, such as an isolated foreign body, without causing any damage to my gastrointestinal tract. Ischemia, necrosis, perforation and even strangulation can be seen due to sandwich compression in most patients who swallow multiple magnetic foreign bodies. In rare cases, spontaneous gastrointestinal release is possible in multiple magnetic FB ingestion. In case of multiple magnetic FB ingestion, patients who are asymptomatic can be followed. Successful results are obtained with more non-invasive treatment by applying timely and correct procedures.

Keywords:

child, buckyball, intestinal perforation, magnetic foreign body,

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