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Foreign Body in the Upper Gastrointestinal Tract in Infants and Children

Journal of the Korean Pediatric Society 1993;36(1):17-24.
Published online January 15, 1993.
Foreign Body in the Upper Gastrointestinal Tract in Infants and Children
Sang Heui Song, Ki Sup Chung
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
소아의 상부 위장관내 이물질에 대한 임상적 및 내시경적 고찰
송상희, 정기섭
연세대학교 의과대학 소아과학교실
Abstract
The accidental swallowing of foreign bodies by infants and children is a common problem. The proper methods of therapy must be carefully selected according to the age of the patient, the type of foreign body, the location of impaction, the duration of ingestion, and the available medical resoruces and skills. This report reviews 41 cases of ingested foreign bodies in the upper GI tract at the Department of Pediatrics, Yonsei University College of Medicine between January 1981 and June 1991. The results were as follows: 1) The ages ranged from 3 months to 13 years with 34 cases less than 5 years of age, 5 cases between 5 to 10 years of age, and 2 cases greater than 10 years of age. 2) The male to female ratio was 1.9:1 with 27 male and 14 female patients. 3) The types of ingested foreign bodies were coins in 15 cases(6.6%), pins in 9 cases(22.0%), rings in 3 cases, food in 3 cases, nails in 2 cases, and others. 4) Presenting symptoms were variable with vomiting in 8 cases(19.5%), coughing in 4 cases(9.8%), dysphagia in 4 cases(9.8%), poor oral intake in 2 cases(4.9%), diarrhea in 2 cases(4.9%), and others. 5) Ingested foreign bodies were located in the esophagus in 14 cases(34.2%), stomach in 24 cases(58.5%), duodenum in 1 cases(2.4%) and uncertain locations in 2 cases. 6) Methods for the removal of ingested foreign bodies included 15 cases of endoscopic removal(53.6%), 1 surgical removal(3.6), and 12 spontaneous removals(42.8%). 10 endoscopic removals were carried out in 12 esophageal cases(83.3%), but 10 out of 16 stomach cases were removed spontaneously(62.5%). 7) Duration from ingestion to removal of foreign bodies ranged from 19 hours to 2 years. All 12 spontaneous removal cases were within 2 weeks, and 1 surgical case was performed 2 years after ingestion. 8) Endoscopic findings of patients with esophageal foreign bodies included 3 normal cases(30.0%) and 7 moderate to severe abnormal cases&70.0%), and those patients with gastric foreign bodies included 3 normal cases(60.0%) and 2 mild superficial mucsal lesion cases.
Key Words: Foreign body ingestion, Endoscopy, Gastrointestinal tract


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