Pediatric esophagus foreign body
Introduction
Introduction to children's esophageal foreign body Children's esophageal foreign body is caused by children's joy to contain items in the mouth, and accidentally swallowed to cause esophageal foreign bodies. Common foreign objects are coins, buttons, miniature batteries, pins, plastic covers, bone pieces, jujube cores, etc. Since the esophagus is a muscle duct with a large elasticity, most foreign bodies that enter the esophagus can be sent into the stomach with swallowing and creeping, and most of the foreign bodies that remain in the esophagus are irregular and irregular shapes. Generally, it remains in the first narrow part of the esophagus, and can also stay in the second narrow part of the thoracic segment, which is equivalent to the level of the aortic arch. Most of the second narrow foreign matter can be discharged into the stomach. basic knowledge The proportion of illness: 0.001% Susceptible people: children Mode of infection: non-infectious Complications: esophagitis Esophageal perforation
Cause
Pediatric esophageal foreign body etiology
Food factor (25%):
Inadvertently slipping into the lower pharynx into the esophagus when eating and chewing, such as fishbone or chicken bones, it is difficult to chew completely food, such as glutinous rice cake, jelly. Incomplete development of teeth in children can also lead to.
Foreign body factor (55%):
Children will accidentally swallow the shaped instruments contained in the mouth or play into the esophagus, such as paper clips and various sharp foreign objects. Since the esophagus is a muscle duct with greater elasticity, most foreign objects entering the esophagus can be sent to the stomach with swallowing and peristalsis. Inside, most of the large and irregularly shaped foreign bodies remaining in the esophagus generally remain in the first narrow part of the esophagus, and can also stay in the second stenosis of the thoracic segment, equivalent to the level of the aortic arch, passing through the second stenosis. Most foreign bodies can be discharged into the stomach.
Pathogenesis
Foreign bodies of the esophagus can damage the local esophageal mucosa. Small foreign objects only cause abrasion of the esophageal mucosa or form a small limited hematoma and erosion. Generally, no serious consequences are caused. Large and sharp foreign objects can pierce the whole esophagus and even Perforation of the esophagus, especially in the second narrow space, such as penetrating the esophageal wall, involving the aortic wall, can occur aortic esophageal spasm, causing fatal bleeding and death, due to local tissue damage plus infection from the mouth Adhesion of tissues in the esophageal foreign body remains, forming an esophageal inflammation or a localized abscess. Further enlargement of the abscess can cause mediastinal infection and spread to surrounding tissues.
Prevention
Pediatric esophageal foreign body prevention
Esophageal foreign bodies are completely preventable, and parents and childcare workers should be widely educated to strengthen infant and child care.
Children under the age of 1.3 have not yet erupted, and should not be given peanuts, seeds, beans and other foods with nuclear.
2. Do not choose toys that are dangerous for children. Items that may be inhaled or swallowed by young children should not be used as toys.
3. Do not run around when eating in children, so as not to swallow foreign objects when falling.
4. Don't be scared when eating, amused or scolded, so as not to cry, laugh and swallow.
5. Educate children to get rid of bad habits such as pens, whistle and small toys.
6. When critically ill and comatose patients eat, special attention should be paid to prevent accidental swallowing.
Complication
Pediatric esophageal foreign body complications Complications esophagitis esophageal perforation
Small babies are crying, sucking and oppressing large foreign bodies, causing hoarseness, coughing, wheezing, and even suffocation. Common complication of esophageal foreign body is esophagitis, esophageal perforation, esophageal fistula, mediastinal inflammation, peri-esophage abscess or upper mediastinal abscess, occasionally visible respiratory infection. Such as local inflammation or foreign body injury and aortic bleeding can occur, life-threatening.
Symptom
Pediatric esophageal foreign body symptoms Common symptoms Children crying uncomfortable swallowing painful sputum refusal to eat eating difficulties hoarse hoarseness suffocation after sternum foreign body obstruction...
Most of the clinical patients have a history of swallowing foreign bodies. Small babies will not express them. Family members can also find that toys that are playing are gone. Children who swallow foreign bodies initially have obvious pharyngeal or esophageal sensation, swallowing pain. , hooliganism, difficulty eating, vomiting, refusal of milk, spitting bleeding when there is a laceration of the esophageal mucosa, small infants appear crying, aspiration and large foreign body oppression, resulting in hoarseness, cough, wheezing, and even suffocation.
Examine
Pediatric esophageal foreign body inspection
Concurrent infection often has bloody infection, white blood cells and neutrophils increased. X-ray examination is the main method for confirming esophageal foreign body. It can not only clarify the traits and location of esophageal foreign bodies, but also an important means to diagnose whether or not to merge with esophageal perforation. The positional film can display X-ray foreign body images, such as foreign objects suspected to be undeveloped, and can be diagnosed by esophageal angiography. Most of them can be diagnosed. For example, when combined with esophageal perforation, it can be expressed as free gas in the cervical tissue, soft tissue before the vertebrae. Widening due to inflammation, tracheal advancement, clear esophageal foreign body can be directly esophageal endoscopy, try to remove foreign bodies, the treatment of patients who have caused perforation of the esophagus or microscopically taken foreign bodies should be treated surgically.
Diagnosis
Diagnosis and diagnosis of children's esophageal foreign body
According to the history and clinical features, it is easy to diagnose, and it is distinguished from spontaneous esophageal rupture. It mainly relies on the history of foreign body swallowing and auxiliary examination, and it is found that there is foreign body in the esophagus. Spontaneous esophageal rupture refers to a longitudinal tearing of the entire left side wall of the esophagus on the adjacent diaphragm due to a sudden increase in pressure within the lumen. Also known as Boerhaave syndrome, spontaneous esophageal tear syndrome, esophageal pressure rupture.
