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      Cuerpo extraño gastrointestinal en niños Translated title: Gastrointestinal foreign body in children

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          Abstract

          Los cuerpos extraños (CE) gastrointestinales son motivo de consulta frecuente en los servicios de urgencia, siendo los esofágicos los de mayor riesgo Los síntomas de presentación son variados y dependen de la ubicación del CE, existiendo diversas técnicas para su extracción. Objetivo: Describir las características de la población consultante y de los CE retirados por endoscopia en niños. Pacientes y Método: Se realizó una revisión de los últimos 6 años, de las fichas de los pacientes a los que se le indicó una endoscopía digestiva por CE gastrointestinal. Se utilizó estadística descriptiva para el análisis de los datos. Resultados: 51 pacientes, 28 hombres y 23 mujeres, con un promedio de edad de 4 años, fueron sometidos a endoscopía digestiva por ingesta de CE. Los síntomas de presentación más frecuentes fueron la sialorrea (45%) y la disfagia (35%), siendo extraídos los CE en su mayoría con anestesia general. Los CE más frecuentemente fueron monedas (57%) y se ubicaron principalmente en esófago (91%). Todos se extrajeron mediante endoscopía directa o con asistencia endoscópica y las lesiones encontradas fueron erosiones en 19 (37%) pacientes y úlceras en 4 (8%). No hubo complicaciones. Conclusiones: La extracción endoscópica de CE gastrointestinales es un procedimiento seguro. Dado el riesgo de lesiones graves, especialmente en los CE de ubicación esofágica, debe considerarse siempre la realización de la endoscopía dentro de un plazo prudente. Los protocolos de manejo son necesarios para unificar los criterios de las personas que trabajan en los servicios de urgencia teniendo presente que la estrategia más importante es la prevención.

          Translated abstract

          Gastrointestinal foreign bodies (FB) are frequent complaints in the emergency departments, with esophageal foreign bodies as the most frequent cases. Symptoms are varied and depend on the location of the FB, with several techniques available for removal. Objective: To describe the FB removed by endoscopy in children as well as the consulting population characteristics. Patients and Method: Patient chart reviews of those who, during the last six years, underwent gastrointestinal endoscopy were performed. Descriptive statistics were used to analyze the data. Results: 51 patients, 28 males and 23 females, with average age of four years old, underwent endoscopy due to FB intake. The most common symptoms were drooling (45%) and dysphagia (35%); the FBs were extracted mostly under general anesthesia. Coins were the most common foreign bodies found (57%) and they were mainly located in the esophagus (91%). All bodies were extracted by direct endoscopy or endoscopically assisted extraction; lesions that corresponded to erosions were found in 19 (37%) patients and ulcers in 4 (8%). There were no complications. Conclusions: Endoscopic removal of gastrointestinal FBs is a safe procedure. Given the risk of serious injury, especially in foreign bodies in the esophagus, performing endoscopy within a reasonable time must always be considered. Management protocols are necessary to unify the standards of those working in emergency rooms, having in mind that the most important strategy is prevention.

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          Most cited references32

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          Management of ingested foreign bodies and food impactions.

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            Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies.

            Ingesting a foreign body (FB) is not an uncommon occurrence. Most pass through the gastrointestinal (GI) tract uneventfully, and perforation is rare. The aim of this study was to report our experience with ingested FB perforations of the GI tract treated surgically at our institution. A total of 62 consecutive patients who underwent surgery for an ingested FB perforation of the GI tract between 1990 and 2005 were retrospectively reviewed. Three patients with no definite FB demonstrated intraoperatively were included. The patients had a median age of 58 years, and 37 (60%) were male. Of the 59 FBs recovered, 55 (93%) were toothpicks and dietary FBs such as fish bones or bone fragments. A definitive preoperative history of FB ingestion was obtained for only two patients, and 36 of 52 patients (69%) wore dentures. Altogether, 18 (29%) perforations occurred in the anus or distal rectum, and 44 perforations were intraabdominal, with the most common abdominal site being the distal ileum (39%). Patients with FB perforations in the stomach, duodenum, and large intestine were significantly more likely to be afebrile (P = 0.043), to have chronic symptoms (> 3 days) (P < 0.001), to have a normal total white blood cell count (P < 0.001), and to be asymptomatic or present with an abdominal mass or abscess (P < 0.001) compared to those with FB perforations in the jejunum and ileum. Ingested FB perforation in the adult population is most commonly secondary to unconscious accidental ingestion and is frequently caused by dietary FBs especially fish bones. A preoperative history of FB ingestion is thus rarely obtained, although wearing dentures is a common risk factor. FB perforations of the stomach, duodenum, and large intestine tend to present with a longer, more innocuous clinical picture than perforations in the jejunum or ileum.
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              2000 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.

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                Author and article information

                Journal
                rcp
                Revista chilena de pediatría
                Rev. chil. pediatr.
                Sociedad Chilena de Pediatría (Santiago, , Chile )
                0370-4106
                December 2014
                : 85
                : 6
                : 682-689
                Affiliations
                [03] Valparaíso orgnameHospital Dr. Gustavo Fricke orgdiv1Unidad de Cirugía Infantil Chile
                [02] orgnameUniversidad de Chile orgdiv1Facultad de Medicina orgdiv2Departamento Pediatría y Cirugía Infantil Chile
                [01] orgnameHospital Dr. Luis Calvo Mackenna orgdiv1Unidad Gastroenterología y Nutrición Infantil Chile
                [04] Santiago orgnameHospital Dr. Luis Calvo Mackenna orgdiv1Servicio Cirugía Infantil Chile
                Article
                S0370-41062014000600005 S0370-4106(14)08500600005
                10.4067/S0370-41062014000600005
                25697614
                7c53cb8b-6fda-40bc-8028-d233ec14328a

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 14 November 2014
                : 05 November 2013
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 8
                Product

                SciELO Chile

                Categories
                ARTÍCULOS ORIGINALES

                Endoscopia,gastrointestinal,cuerpo extraño,pediatría,Endoscopy,pediatrics,foreign body

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