31st Annual Congress of Turkish Pediatric Surgical Association

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Poster - 113

A Case Report With A Fast Clinical Presentation Of A Sharp Pointed Foreign Body Ingestion

Foreign body ingestion is a serious problem that is especially seen in children aged three months to six years. Many patients who have swallowed foreign bodies are asymptomatic. Plain radiographs generally are used for the identification of the ingested foreign body. Its treatment consists of observation, endoscopy,  Foley and bougienage techniques and surgery. Button batteries and sharp objects lodged in the esophagus require urgent endoscopic removal because of their complications such as  caustic erosion and perforation. Objects that have passed the esophagus generally do not cause symptoms if complications, such as bowel perforation or obstruction, do not occur. Although sharp objects have an increased risk of complications such as bowel obstruction, perforation, and erosion into adjacent organs once they are beyond the esophagus most of them pass without any complication. At this report we wanted to share a case with a quick clinical presentation that swallowed a quilting needle.

Six months old, male child was taken to emergency department because his family witnessed that he had ingested a quilting needle about one hour ago. At the physical examination a palpable hyperemic puffiness with approximately 1 cm diameter was detected at the right  of the epigastrical location. When anteroposterior and lateral radiographs were taken, the swallowed needle was indicated in the subcutaneous tissue at the abdomen under the palpable hyperemic  mass.  A 1 cm incision was made to the subcutaneous tissue of the abdomen under anesthesia and a foreign body (a quilting needle) was taken out of the body. Preoperative and postoperative periods were both problem free so he was discharged from the hospital with medical advices.

Foreign body ingestion is a common serious problem of pediatric surgery and physical examination must be considered carefully. In the literature we have not detected a foreign body that comes out of the body through abdomen wall at such a short period of time.

Çabuk Klinik Bulgu Veren Sivri Uçlu Bir Yabancı Cisim Yutma Öyküsü Olan Olgu

Yabancı cisim yutulması özellikle 3 ay-6 yaş arası çocuklarda ciddi bir problemdir. Yabancı cisim yutan birçok hasta asemptomatiktir. Tanıda genellikle direk grafi kullanılır. Tedavi izlem, endoskopi, Foley ve buji teknikleri ve cerrahiyi içermektedir. Özofagusta takılı kalan piller ve sivri uçlu cisimler kostik erozyon ve perforasyon gibi komplikasyonlar nedeniyle acil endoskopik müdahaleyi gerektirir. Keskin objelerin barsak obstrüksiyonu, perforasyon ve komşu organlara erozyon gibi artmış riskleri bulunmasına rağmen bir kez özofagusu geçtikten sonra çoğunlukla herhangibir komplikasyona neden olmazlar. Bu raporda hızlı klinik bulgu veren sivri uçlu bir yabancı cisim yutma öyküsü bulunan olguyu paylaşmak istedik.

6 aylık erkek olgu acil servise getirildi, ailesi yaklaşık 1 saat önce bir iğne yuttuğunu gördüklerini söylediler. Fizik muayenede epigastrik bölgenin sağında yaklaşık 1 cm çapında palpable hiperemik bir şişlik saptandı. Anteroposterior ve lateral grafiler çekildiğinde abdomende palpable hiperemik kitlenin altında subkutanöz dokuda yutulmuş olan iğnenin bulubduğu saptandı. Anestezi altında subkutanöz dokuya yapılan 1 cm’lik kesi ile yabancı cisim (yorgan iğnesi) çıkarıldı. Preoperatif ve postoperatif sorunsuz olması nedeniyle tıbbi önerilerle olgu taburcu edildi.

Yabancı cisim yutulması çocuk cerrahisinde sık ve ciddi görülen bir problemdir ve fizik muayene dikkatli bir şekilde yapılmalıdır. Literatürde abdomen duvarı yoluyla vücuttan dışarı bu kadar kısa sürede çıkan bir yabancı cisme rastlamadık.

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