Foreign bodies in the upper gastrointestinal tract in children, modern approaches to removal. A clinical case
Background. The problem of providing emergency care to children who have swallowed sharp foreign bodies remains relevant and requires addressing the following issues: the timeliness of such care, the diagnostic algorithm for determining the nature of a foreign body, and the methodological aspects of...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Zaslavsky O.Yu.
2024-12-01
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| Series: | Zdorovʹe Rebenka |
| Subjects: | |
| Online Access: | https://childshealth.zaslavsky.com.ua/index.php/journal/article/view/1777 |
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| Summary: | Background. The problem of providing emergency care to children who have swallowed sharp foreign bodies remains relevant and requires addressing the following issues: the timeliness of such care, the diagnostic algorithm for determining the nature of a foreign body, and the methodological aspects of the endoscopist’s procedure. The purpose of this study is to improve the technique for removing a fixed sharp-pointed foreign body from a child’s esophagus. Materials and methods. The article describes a clinical case of endoscopic removal of a 2-cm long open safety pin lodged in the upper esophageal sphincter with the sharp end up. Results. The endoscopic procedure to remove an impacted sharp foreign body from the esophagus was conducted in three steps. The first stage involved the sequential and safe moving the open safety pin to the stomach to reorient it with the sharp end pointing downward, thereby preventing injury to the cardiac sphincter and the esophageal orifice during its removal. The second stage involved rotating and reorienting the safety pin so that the sharp end pointed downward. The third stage involved the secure fixation of a foreign body with the sharp end pointing downward and its slow, careful removal. Conclusions. Children suspected of having a foreign body in the upper gastrointestinal tract should be urgently assessed and treated in the surgical department of a specialized multidisciplinary hospital. The most effective way to provide this type of care is to centralize it in a single regional facility that is fully equipped with specialized equipment and instruments. Flexible endoscopy is the preferred method for removal of foreign bodies found in the upper gastrointestinal tract. A combination of radiographic and endoscopic examinations is necessary to determine the nature of a foreign body and to investigate the cause of its fixation in the lumen. To prevent perforation of the hollow organ, endoscopic procedures in children must be carried out under general anesthesia in a surgical setting. The use of appropriate flexible endoscopes, considering the age-related anatomical and physiological characteristics, minimizes trauma to the esophageal wall and reduces the risk of perforation of the hollow organ wall. |
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| ISSN: | 2224-0551 2307-1168 |