Öz
Amaç:beslenme ya da solunum yolunda yabancı cisim olması erişkinlerde acil başvurularının sık bir nedenidir.
Hastalar ve Yöntem:bu çalışma 3. Basamak acil servise başvuran hastalarla, tek merkezli, retrospektif olarak yapıldı.18 yaş üzeri, gebe olmayan, travması olmayan ve dosyalarında yeterli veriye ulaşılabilen hastalar çalışmaya alındı. Hastaların yaşı, cinsiyeti, alımın nedeni (yanlışlıkla, suicid amaçlı, cinsel amaçlı), cismin türü, yapılan tetkikler, uygulanan tedavi yöntemi, komplikasyon ve mortalite durumu kaydedildi.
Bulgular:Çalışmaya alınan 189 hastanın yaş ortalaması 36, hastaların %59,2’si kadın olarak bulundu. Hastaların %86,2’si yanlışlıkla, %10,6’sı suicidal amaçlı ve %3,2’si cinsel amaçlı almıştı. Yanlışlıkla alımlar kadınlarda fazla saptanırken, self harm amaçlı alımlara sadece erkeklerde rastlandı. Yanlışlıkla alımlarda en fazla kılçık, iğne, gıda, sarımsak ve diş e rastlandı. Self harm amaçlı alımlarda en fazla kullanılan maddeler jilet, çivi gibi keskin cisimlerdi. Olguların %40,7’sine fleksiblelaringoskopi, %57,6’sına endoskopik girişim yapıldı. %61,3’ünden yabancı cisim fleksiblelaringoskopi ve endoskopik girişim ile çıkarılırken; %6,9’una cerrahi işlem yapıldı. Yabancı cisimlerin en sık rastlandığı yerler ise en sık larenks- farenks, ösefagus ve midede olarak bulundu. komplikasyona rastlanmadı. hastalardan hiçbiri ölmedi.
Sonuç:Yabancı cisimlerin yutulması dünya çapında yaygın bir klinik problemdir. Hastanemize yabancı cisim yutulma şikayetiyle başvuruların çok olması nedeniyle acil servis ve gastroentereoloji klinikleri bu konuda tecrübeli ve deneyimlidir. Çalışmamızın sonucunda, yüksek başarı ve düşük komplikasyon oranı nedeniyle Endoskopik yaklaşım en güvenilir ve efektif yöntem olarak değerlendirilmiştir.
Anahtar Kelimeler
Kaynakça
- 1- Hong K.H, Kim Y.J, Kim J.H, Chun S.W, Kim H.M, Cho J.H. Risk FactorsForComplicationsAssociatedWithUpperGastrointestinalForeignBodies. World J Gastroenterol2015 July 14; 21(26): 8125-8131.
- 2- Choi P.W, SurgicalRemoval of MultipleGastricForeignBodies. Case Report. AmericanJournal of Medical Case Reports, 2019, Vol. 7, No. 1, 1-4.
- 3- Nicolodi G. C, TrippiaC.R,.Caboclo M.F.F.S, de Castro F.G, Wagner Peitl Miller W.P, de Lima R.R.et alIntestinalPerforationBy An İngestedForeign Body. RadiolBras. 2016 Set/Out;49(5):295–299.
- 4- Kızıltan R, Yılmaz Ö, Aras A, Toktaş O, Batur A, Ağar F et al. IngestedIntraabdominalForeignBodiesThatRequireSurgicalIntervention. Ulus Travma Acil Cerrahi Derg2016;22(3):269–272.
- 5- Birk M, Bauerfeind P, Deprez P.H, Häfner M, Hartmann D, Hassan C et alRemovalOf ForeignBodies in TheUpperGastrointestinalTract in Adults: EuropeanSociety of GastrointestinalEndoscopy (ESGE) ClinicalGuideline. Endoscopy 2016; 48: 489–496
- 6- Palta R, Sahota A, Bemarki A, Salama P, Simpson N, Laine L. Foreign-Body Ingestion: CharacteristicsAndOutcomes in A LowerSocioeconomicPopulationWithPredominantlyIntentionalIngestion. GastroıntestınalEndoscopy Volume 69, No. 3 :Part 1 of 2 : 2009.
- 7- GeraciG ,Sciume C, Di Carlo G, Picciurro A, Modica G. Retrospective Analysis Of Management Of IngestedForeignBodiesAndFoodImpactions in EmergencyEndoscopicSetting in Adults. BMC EmergencyMedicine (2016) 16:42.
- 8- Li Z.S, Sun Z.X, Zou D.W, Xu G.M, Wu R.P, Liao Z. Endoscopic Management Of ForeignBodiesin TheUpper-GI Tract: ExperienceWith 1088 Cases in China. GastrointestinalEndoscopy. 2006;64(4): 485-492.
- 9- Okan İ, Akbaş A, Küpeli M, Yeniova A.Ö, Esen M, Özsoy Z, Management Of Foreign Body IngestionAndFoodImpactionin Adults: A Cross-SectionalStudy. Ulus Travma Acil Cerrahi Derg 2019;25(2):159-166.
- 10- Robertson A. R. Self-harmbySharpForeign Body Ingestion. Suicide Life ThreatBehav. 2019;49(3):735-738.
- 11- Coskun A, Erkan N, Yakan S, Yıldirim M, Cengiz F. Management of rectalforeignbodies. World Journal of EmergencySurgery 2013; 8(11):2-5.
- 12- Yildiz S.Y, Kendirci M, Akbulut S, Ciftci A, Turgut H.T, Hengirmen S. ColorectalEmergenciesAssociatedWithPenetratingOrRetainedForeignBodies. World Journal of EmergencySurgery 2013; 8(25):2-5.
- 13- Principe D.R, Rubin J, Narbutis M, CabreraJ,Mitsiev I. Repeat Presentation Of LargeRectalForeign Body RequiringSurgicalIntervention. Journal of Surgical Case Reports, 2019;4:1–3.
Öz
Purpose:A foreign body in the airway or gastrointestinal system is a common cause of emergency presentations in adults.
Patients and Methods:This single center, retrospective study involved patients presenting to a third-tier emergency department with foreign bodies in the airway or gastrointestinal system. Non-traumatic, non-pregnant patients aged 18 or over were scanned through the ICD-10 diagnostic code. Age and sex, reasons for ingestion/insertion (unintentional, for suicide, or for sexual gratification), the type of object, test data, treatment, complications and mortality were recorded.
Results:The mean age of the 189 patients included was 36, and 59.2% were women. Ingestion was unintentional in 86.2%, for suicide in 10.6%, and for sexual gratification in 3.2%. Unintentional ingestion was more common in women, while ingestion for self-harm was unique to men. Fish bones, pins, garlic, and teeth were most frequently encountered in unintentional ingestions. The most commonly ingested objects for self-harm were sharp items such as razor blades and nails. Flexible laryngoscopy was employed in 40.7% of cases and endoscopic interventions in 57.6%. Foreign bodies were removed with flexible laryngoscopy or endoscopy in 61.3% of cases, and surgery was performed on 6.9%. Foreign bodies were most encountered in the larynx-pharynx, esophagus, and stomach.None of the patients died. No complications were detected.
Conclusion:Foreign body ingestion is a widespread, global clinical problem. Our hospital receives many presentations involving foreign body ingestion, and the emergency and gastroenterology departments have considerable experience in this area. The endoscopic approach was the safest and most effective method due to its high success and low complication rates.
Anahtar Kelimeler
emergency department foreign body diagnose emergency management
Kaynakça
- 1- Hong K.H, Kim Y.J, Kim J.H, Chun S.W, Kim H.M, Cho J.H. Risk FactorsForComplicationsAssociatedWithUpperGastrointestinalForeignBodies. World J Gastroenterol2015 July 14; 21(26): 8125-8131.
- 2- Choi P.W, SurgicalRemoval of MultipleGastricForeignBodies. Case Report. AmericanJournal of Medical Case Reports, 2019, Vol. 7, No. 1, 1-4.
- 3- Nicolodi G. C, TrippiaC.R,.Caboclo M.F.F.S, de Castro F.G, Wagner Peitl Miller W.P, de Lima R.R.et alIntestinalPerforationBy An İngestedForeign Body. RadiolBras. 2016 Set/Out;49(5):295–299.
- 4- Kızıltan R, Yılmaz Ö, Aras A, Toktaş O, Batur A, Ağar F et al. IngestedIntraabdominalForeignBodiesThatRequireSurgicalIntervention. Ulus Travma Acil Cerrahi Derg2016;22(3):269–272.
- 5- Birk M, Bauerfeind P, Deprez P.H, Häfner M, Hartmann D, Hassan C et alRemovalOf ForeignBodies in TheUpperGastrointestinalTract in Adults: EuropeanSociety of GastrointestinalEndoscopy (ESGE) ClinicalGuideline. Endoscopy 2016; 48: 489–496
- 6- Palta R, Sahota A, Bemarki A, Salama P, Simpson N, Laine L. Foreign-Body Ingestion: CharacteristicsAndOutcomes in A LowerSocioeconomicPopulationWithPredominantlyIntentionalIngestion. GastroıntestınalEndoscopy Volume 69, No. 3 :Part 1 of 2 : 2009.
- 7- GeraciG ,Sciume C, Di Carlo G, Picciurro A, Modica G. Retrospective Analysis Of Management Of IngestedForeignBodiesAndFoodImpactions in EmergencyEndoscopicSetting in Adults. BMC EmergencyMedicine (2016) 16:42.
- 8- Li Z.S, Sun Z.X, Zou D.W, Xu G.M, Wu R.P, Liao Z. Endoscopic Management Of ForeignBodiesin TheUpper-GI Tract: ExperienceWith 1088 Cases in China. GastrointestinalEndoscopy. 2006;64(4): 485-492.
- 9- Okan İ, Akbaş A, Küpeli M, Yeniova A.Ö, Esen M, Özsoy Z, Management Of Foreign Body IngestionAndFoodImpactionin Adults: A Cross-SectionalStudy. Ulus Travma Acil Cerrahi Derg 2019;25(2):159-166.
- 10- Robertson A. R. Self-harmbySharpForeign Body Ingestion. Suicide Life ThreatBehav. 2019;49(3):735-738.
- 11- Coskun A, Erkan N, Yakan S, Yıldirim M, Cengiz F. Management of rectalforeignbodies. World Journal of EmergencySurgery 2013; 8(11):2-5.
- 12- Yildiz S.Y, Kendirci M, Akbulut S, Ciftci A, Turgut H.T, Hengirmen S. ColorectalEmergenciesAssociatedWithPenetratingOrRetainedForeignBodies. World Journal of EmergencySurgery 2013; 8(25):2-5.
- 13- Principe D.R, Rubin J, Narbutis M, CabreraJ,Mitsiev I. Repeat Presentation Of LargeRectalForeign Body RequiringSurgicalIntervention. Journal of Surgical Case Reports, 2019;4:1–3.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Acil Tıp |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Temmuz 2021 |
| Gönderilme Tarihi | 19 Mart 2020 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 12 Sayı: 3 |
