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題名 | Therapeutic Endoscopy: Removal of Gastrointestinal Foreign Bodies in Children=治療性內視鏡:兒童消化道異物之移除 |
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作者姓名(外文) | Seo,Jeong Kee; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 38:3 民86.05-06 |
頁次 | 頁183-186 |
分類號 | 417.5411 |
關鍵詞 | 治療性內視鏡; 兒童; 消化道異物; Endoscopy (gastrointestinal); Foreign body; Children; |
語文 | 英文(English) |
英文摘要 | Endoscopic removal of foreign bodies (FBs) is an important part of therapeutic endoscopy in children. The majority of FB ingestion occur in children under 5 years. Children most often ingest coins, pins, keys, round stones or marbles, nails, rings, batteries and toys, and coins are the most common in the pediatric series of 139 children, who underwend endoscopic removal in Seoul National University, Children's Hospital. The management of FBs in children depends on the type (sharp or dull, pointed or blunt, and toxic or nontoxic) and the size, along with the location of FB in the gastrointestinal tract. The endoscopist should decide whether endoscopic intervention is necessary and how urgently it has to be done. Idications for removal of FBs from the gastrointestinal tract in children are 1) all esophageal FBs. 2) gastric and duodenal FBs if they are sharp or pointed, if more than 4 cm long or 2 cm wide in young infants and chilfren, if containing toxic substances and if blunt objects after 2 weeks observation in the stomach or 1 week observation in the duodenum. All FBs impacted in the esophagus should be removed within 24 hours because of the risks of perforation and serious fistula formation. Disk batteries can cause corrosive injury to the esophagus within 4 hours, and shuold be removed as soon as possible. Coin retrieval can be done very securely be the W-shape FB grasping forcep without an endotracheal general anesthesia. Blunt FBs, such as marbles can be best removed with a stone retrieval basket, which can be made from a condom. Disk batteries can not be grasped with the FB forceps and snares, but very safely with the powerful magnet attached to the tip of the scope. Overtubes and protective rubber hoods are useful for removing sharp or pointed objects. It is important to test the available grasping accessories on a duplicate of the FB as a "dry run" to determine which accessories will grasp the FB securely. |
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