Clinical analysis of 32 children with perforation caused by foreign body in upper gastrointestinal tract / 中华实用儿科临床杂志

ABSTRACT

Objective:To explore the clinical characteristics and treatment strategies of upper gastrointestinal perforation caused by ingested foreign bodies in children.Methods:A retrospective analysis of 32 patients with upper gastrointestinal perforation secondary to foreign bodies in Henan Children′s Hospital from January 2011 to February 2019 was performed.Some basic information was collected, including age, gender, type of foreign bodies, location of perforation, time of swallowing, clinical symptoms, treatment methods and outcomes.Results:Among the 32 children, there were 20 cases (62.5%) were male and 12 cases (37.5%) were female.The predilection age was 0 to <3 years old [21 cases (65.6%)]. The most common type of upper gastrointestinal foreign bodies was jujube pits [13 cases (40.6%)], followed by button batteries [10 cases (31.2%)], magnets [3 cases (9.4%)], fish bones [2 cases (6.3%)], lollipop stick [2 cases (6.3%)], button battery combined with magnet [1 case (3.1%)] and metal pin [1 case (3.1%)]. Majority of perforation was located in the esophagus [25 cases (78.2%)], especially in the upper esophagus [15/25 cases, (60.0%)]. The common symptoms of upper gastrointestinal perforation include fever [22 cases (68.8%)], dysphagia and/or salivation [21 cases (65.6%)], vomiting [24 cases (75%)], abdominal pain [5 cases (15.6%)] and expiratory dyspnea [1 case (3.1%)]. All the foreign bodies were successfully extracted by endoscopy [28 cases (87.5%)] and surgery [4 cases (12.5%)]. Moreover, all the patients recovered with both treatments of indwelling gastrointestinal decompression tube and enteral nutrition, including nasojejunal tube [24 cases (75.0%)], endoscopic hemoclip and nasojejunal nutrition [2 cases (6.3%)], and surgical operation [6 cases (18.7%)].Conclusions:The upper gastrointestinal foreign body is a common emergency in children, and might cause perforation, especially jujube pits, button batteries and magnets.The endoscopic procedure is safe and effective for the removal of foreign bodies.However, the surgical intervention is required as soon as possible due to the failure of endoscopic treatment.