Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 6 , ISSUE 3 ( September-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados

Julio Trostchansky, Gabriel Masaferro

Citation Information : Trostchansky J, Masaferro G. Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados. Panam J Trauma Crit Care Emerg Surg 2017; 6 (3):146-154.

DOI: 10.5005/jp-journals-10030-1185

License: CC BY 3.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objetivo

Analizar las características de los pacientes asistidos por ingesta de cuerpo extraño en el Departamento de Emergencia del Hospital Maciel y llegar al diseño de guías de actuación en el contexto de un equipo multidisciplinario.

Resultados

Nuestra serie constó de 31 consultas por ingesta de cuerpo extraño. El 52% provenía de instituciones psiquiátricas y el 42% eran reclusos, un caso no pertenecía a ninguna de las 2 categorías. El 27,5% de las consulta se habían producido en las primeras 24hs desde la ingesta, el 24% de las ingestas se habían producido con más de una semana desde la ingesta y el resto oscilaba entra ambos tiempos evolutivos En cuanto a la conducta, en 12 casos se otorgó el alta sin mediar conducta activa endoscópica y/o quirúrgica. Se realizó una FGC en el 64% de los casos en los cuales se constató radiológicamente la ingesta de un cuerpo extraño, siendo efectivamente terapéuticas para la extracción de objetos a nivel gastroduodenal en el 67% de las mismas. De las 28 consultas por ingesta de CE 6 pacientes (21%) fueron operados. En 5 de ellos por falla de la extracción endoscópica, el restante se presentó como una peritonitis aguda. La ingesta de CE representa una patología de consulta frecuente en el Departamento de Emergencia. El manejo del mismo se realiza mediante un abordaje multidisciplinario que en el caso de nuestra serie mostró porcentajes de extracción endoscópica efectiva cercana al 70% comparable con otras series internacionales. El análisis de las características de la población analizada y el análisis de la evidencia científica publicada nos permite plantear un protocolo de actuación.

How to cite this article

Trostchansky J, Masaferro G. Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados. Panam J Trauma Crit Care Emerg Surg 2017;6(3):146-154.

Objective

To analyze the characteristics of assisted patients due to foreign body ingestion in the Department of Emergency of Maciel Hospital and the design of protocols of action in the context of a multidisciplinary team.

Results

Our series had 31 patients who came for consultation because of foreign body ingestion; 52% came from psychiatric care institutions, 42% were prisoners of state prison, and one case did not belong to any of the previous categories. About 27.5% of consultations occurred within the first 24 hours after ingestion, 24% of consultations in the Department of Emergency occurred after more than 1 week from ingestion, and the rest oscillated between both evolutionary times. Regarding the therapeutic behavior performed, in 12 cases it was decided to discharge the patient without active endoscopic conduct or surgery. A FGC was performed in 64% of cases in which the intake of the foreign body was found radiologically. The FGC was effectively therapeutic for the extraction of objects at the gastroduodenal level in 67% of them. Of the 28 visits to the Department of Emergency for foreign body ingestion, 6 patients (21%) were operated. The reason for this surgery was the failure of endoscopic extraction in 5 of them, the remaining patient presented with acute peritonitis. Ingestion of foreign body represents a pathology of frequent consultation in the Department of Emergency. The management of this clinical situation is carried out through a multidisciplinary approach that, in the case of our series, showed percentages of effective endoscopic extraction close to 70%, comparable with other international series. The analysis of the characteristics of the population studied in our series and the analysis of the published scientific evidence allow us to define a protocol of action of this type of patients in our hospital.


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