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The Fakir Child: Clinical Observation or Invasive Treatment?

机译:Fakir Child:临床观察或侵袭性治疗?

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摘要

Accidental swallowing of foreign bodies is a common problem among the pediatric population (6 months to 3 years), especially if the foreign body (FB) presents a sharp end that could potentially lead to perforation of the gastrointestinal (GI) tract, resulting in infection and complications. We report the case of a 2-year-old, admitted to the Emergency Department of our hospital after ingesting two FBs classifiable as sharp objects, specifically two metal nails, both approximately 4-cm long, which had been swallowed in one go, as reported by the parents. The patient had been previously admitted to another hospital in the same region, where the Emergency Department (ED) doctors took an X-ray to confirm the ingestion. The foreign bodies ingestion was thus confirmed, and they were, according to their report, located in the GI tract over the stomach. The patient has been monitored through all of his stay in the hospital and the progression of the foreign bodies has been documented with serial X-rays. Since neither clinical nor radiological signs of perforation were present, putting the FBs in the small bowel, a non-operative expectant management was followed. After 4 days of admission, the patient had passed one of the two FBS and later on the second one, without any complication. Thereafter the patient was discharged. The management of sharp gastrointestinal foreign objects ingestion is still debated, and the data of the current literature are poor. A number of case reports and small case series describe successful conservative management for the majority of ingested sharp objects. According to the literature data, our report confirms that the ingestion of sharp objects and relatively big objects in a baby can be successfully non-operatively managed, even despite the age of the patient and though the FBs are multiple.
机译:异物的意外吞咽是儿科人口(6个月至3年)之间的常见问题,特别是如果异物(FB)呈现急剧性可能导致胃肠道(GI)道穿孔,导致感染和并发症。我们举报了一个2岁的案件,录取了我们院急诊部门,在摄入两种FBS作为尖锐物体,特别是两个金属钉,大约4厘米长,曾经一次吞咽,如父母报道。患者以前已被录取到同一地区的另一家医院,急诊部(ED)医生采取了X射线来确认摄取。因此确认异物摄取,并根据他们的报告,它们在胃上位于胃肠道。患者通过他在医院的所有住宿中监控,并通过串行X射线记录了外国身体的进展。由于既不存在临床,也不存在放射性迹象,因此将FBS放入小肠中,遵循非操作性期望管理。在入院4天后,患者通过了两种FBS之一,后来在第二个FBS中,没有任何并发​​症。此后患者被排出。急剧胃肠外来物体的管理仍然讨论,目前文献的数据很差。许多案例报告和小型案例系列描述了大多数摄入锋利物体的成功保守管理。根据文献数据,我们的报告证实,即使患者的年龄,虽然FBS是多个,但婴儿中的尖锐物体和相对较大的物体也可以成功地进行尖锐物体和相对大的物体。

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