swallowing a foreign body
Introduction
Introduction to swallowing foreign bodies Foreign body in the gastrointestinal tract is a common abdominal emergency. The vast majority of foreign bodies are swallowed, which occurs in infants and children with mental illness or attempted suicide. There are many clinical symptoms, and foreign bodies can be discharged through the anus. However, some patients need surgery because of difficulty in excretion of foreign bodies or complications. In recent years, due to the popularity and development of endoscopes, some digestive tract foreign bodies can be taken out by endoscopes, thereby reducing the chances of complications and surgical treatment. basic knowledge The proportion of illness: 0.08% Susceptible people: no specific population Mode of infection: non-infectious Complications: gastrointestinal bleeding
Cause
Swallowing foreign body cause
Inadvertent use of children causes swallowing of foreign bodies (90%):
The guardian is not well-behaved and the child is curious, causing foreign bodies swallowed by children to occur. There are many kinds of swallows. Any foreign body that can pass through the esophagus and the cardia can pass through the entire gastrointestinal tract, but according to statistics, there are about 5%. Foreign bodies will be embedded in a certain part of the gastrointestinal tract, especially in the pylorus, duodenum and ileum. Where the foreign body is long, pointed or sharp, there is inflammation or stenosis somewhere in the intestine. Variants, foreign objects are easy to be embedded there.
Prevention
Swallowing foreign body prevention
Prevention method:
1, the guardian's attention in the childhood care should be strengthened, as far as possible in the state of waking children with the care of the accompanying staff.
2, keep children away from foreign objects that can be swallowed, put the size of things that children can put in their mouths in places that children can't reach.
3, do not let children play dangerous things, such as chopsticks, spoons, forks and so on.
4, the parts can be active toys, items should not be allowed to reach children, to avoid children swallowing.
5, if there is an accident, send medical treatment as soon as possible.
Complication
Swallowing foreign body complications Complications, gastrointestinal bleeding
Common complications caused by partial digestive tract foreign bodies are: 1 foreign body is not discharged; 2 digestive tract obstruction; 3 gastrointestinal perforation; 4 abscess formation; 5 internal or external hemorrhoids;
Two cases of duodenal pyelonee were reported in the literature, and one case was infant. The history of swallowing foreign bodies was not asked. The child was hyperthermia and chills. The upper respiratory tract infection was not effective, the urine test was abnormal, and further pyelography was used to confirm the diagnosis. In this case, the formation of sputum is the result of swallowing hairpins, and the causes of complications are:
1 Because the shape of the foreign body is not complete or too long, it cannot pass through the curved part of the gastrointestinal tract, especially the curved part of the second and third segments of the duodenum, which is easy to cause perforation.
2 foreign matter is too large to form an obstruction through the pylorus.
3 sharp foreign bodies are easy to break through the intestinal wall and cause perforation. The risk of perforation is caused by sharp foreign bodies such as chicken bones and toothpicks. The perforation caused by foreign bodies in the digestive tract is about 7% according to Val selivanoV, causing gastrointestinal bleeding. About 1%.
Symptom
Swallowing foreign body symptoms Common symptoms Cold blood in the stool, peritoneal irritation, high fever, peritonitis, abdominal pain, loss of appetite
Foreign body of esophagus can cause pain or difficulty in swallowing, vomiting, no obvious symptoms of foreign body in the stomach, or upper abdominal discomfort, loss of appetite, or pyloric obstruction, spastic pain, vomiting, peritonitis, peritonitis, persistent Abdominal pain, abdominal distension, tenderness, muscle tension, rebound tenderness, etc., long-term incarceration of foreign bodies can cause ulcer bleeding in a certain part, and pointed foreign bodies can directly pierce the mucosa and cause obvious bleeding, patient blood in the stool or hematemesis. The intestinal foreign body penetrates into the renal pelvis to form the duodenal renal pelvis, and the patient has a high fever and chill.
Abdominal signs: small foreign bodies have no local signs, large foreign bodies (such as spoons, toothbrushes) can touch foreign bodies during palpation of the abdomen, local tenderness, peritoneal irritation during gastrointestinal perforation.
Examine
Swallowing foreign body inspection
1. X-ray abdominal plain film: pure metal foreign body X-ray examination, can get a positive diagnosis.
2. Barium meal angiography: Non-metallic foreign body is very helpful through swallowing angiography. If there is bleeding or perforation, it is forbidden to check the barium meal.
Diagnosis
Swallowing foreign body diagnostic identification
Most cases can be diagnosed based solely on medical history. Parents of children can often tell that something is missing in the child's mouth. The larger child can clearly say that something is contained in the exit. Foreign body swallowed into the stomach, foreign matter swallowed without complications such as obstruction or perforation, often no clear signs can be used as a basis for diagnosis, and the final diagnosis is often determined by X-ray examination, including the size of foreign bodies. The shape, the location where it is, whether it is possible to pass by itself or the part that may be embedded.
