Kaan DEMİRÖREN, Ahmet Cumhur DÜLGER, Şehmus ÖLMEZ, VELİ AVCİ, SALİM BİLİCİ, Mehmet MELEK, Halit PULAT

Üst gastrointestinal sistem yabancı cisimleri olan çocuklarda fleksibl endoskopik işlem

Amaç: Çocuklarda ağız yoluyla alınan yabancı cisimler bir halk sağlığı problemi haline gelmiştir. Mevcut çalışmada bu konuya dikkat çekmek ve fleksibl endoskopik yöntemin etkinliğini göstermek amaçlandı. Yöntemler: Çalışmamızda fleksibl endoskopla çıkarma işlemi uyguladığımız, üst gastrointestinal sistemlerinde yabancı cisimleri olan 50 çocuk olguyu retrospektif olarak inceledik. Bulgular: Olguların ortalama yaşı 5,5 ± 4 yıl (yaş aralı- ğı: 0,5-16 yıl) olup %64ü kız idi. Yutulan cisimlerin %58i madeni para, %10u toplu iğne, %6sı pil, %6sı çivi, %6sı kolye, %4ü çengelli iğne ve kalanı da dikiş iğnesi, tel toka, alyans, düğme ve tavuk derisi idi. Cisimlerin %32si üst özofagusta, %26sı orta özofagusta, %8i alt özofagusta, %18i midede, %4ü bulbusta ve %8i duodenum ikinci kısmındaydı. %4 olguda ise endoskopik işlem esnasında yabancı cisim görülmedi. Üç yabancı cisim (%6) özofagustan mideye ittirilerek spontan çıkışa bırakıldı. Kalan %94 cisim ise endoskopla çıkarıldı. Hastalarda önemli bir komplikasyon gelişmedi. Sonuç: Fleksibl endoskop çocuklarda gastrointestinal yabancı cisimleri çıkarmada etkili ve güvenli bir yöntemdir.

Flexible endoscopic procedure in children with foreign bodies in their upper gastrointestinal system

Objective: Foreign body ingestion is an important public health problem. We pointed to this subject and aimed to determine the effectiveness of flexible endoscopic procedure in this study. Methods: We evaluated retrospectively fifty children having foreign body in their upper gastrointestinal system, who underwent flexible endoscopic procedure. Results: Of the patients, mean age was 5.5 ± 4 years old (range: 0.5-16 years), 64% was female. Ingested foreign bodies were coin (58%), pin (10%), battery (6%), nail (6%), necklace (6%), safety pin (4%) and sewing pin, wire hairclip, ring, button and chicken skin. In endoscopic procedure, foreign bodies were seen in upper esophagus (32%), middle esophagus (26%), lower esophagus (8%), stomach (18%), bulbus (4%) and second part of duodenum (8%), but were not seen in 4% of the cases. While 94% of foreign bodies were endoscopically removed, 6% of them were pushed to stomach with gastroscope from esophagus and left for spontaneous passage. Any important complication was developed. Conclusion: Flexible endoscopic procedure is an effective and safe method for removal of gastrointestinal system foreign bodies in children

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