Panamerican Journal of Trauma, Critical Care & Emergency Surgery

Register      Login

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: NA

Published Online: 04-12-2017

Copyright Statement:  NA


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.


HTML PDF Share
  1. Management of ingested foreign bodies: how justifable is a waiting policy? Internet J Surg 2007:9(1).
  2. Guideline for the management of ingested foreign bodies. Gastrointest Endosc 2002;55(7):802-806.
  3. , Rueda JC, Monturiol JM. Foreign body ingestion: management of 167 cases. World J Surgery 1991;15(6):783-788.
  4. Foreign Body Ingestion in Prisoners — The Belfast Experience. Ulster Med J 2008;77(2):110-114.
  5. Foreign body ingestion in children. Am Fam Physician 2005;72:287-291.
  6. Foreign body ingestion in the Emergency Department: case reports and review of treatment. J Emerg Med 1998;16(1):21-26.
  7. Foreign Objects in Korean Prisoners. The Korean Journal of Internal Medicine 2007;22:275-278.
  8. Delayed diagnosis of esophageal perforation by aluminum foreign bodies. Pediatr Radiol 1986;16:511-513.
  9. Risk factors predicting the development of complications after foreign body ingestión. British Journal of Surgery 2003;90:1531-1535.
  10. Removal of a foreign body from the upper gastrointestinal tract with a flexible endoscope: a prospective study. Endoscopy 2004;36:887-892.
  11. Foreign bodies in the appendix. Arch Surg 1971;102:14-20.
  12. Gastrointestinal perforation by chicken bones. Radiology 1979;130:597-599.
  13. Laparoscopic removal of a foreign body from the intestine. J R Coll Surg Edinb 1998;43(2):109-111.
  14. Management of ingested foreign bodies in upper gastroin-testinal tract: report on 170 patients. Indian J Gastroenterol 2003;22(2):46-48.
  15. Esophageal foreign bodies. J Med Assoc Thai 2000;83(12):1514-1518.
  16. Foreign bodies from the upper-aerodigestive tract of children in Puerto Rico. Bol Asoc Med P R 2000;92(9-12):124-129.
  17. Esophageal foreign bodies. Eur J Cardiothorac Surg 1998;13(5):494-498.
  18. Oesophageal foreign bodies. Br Med J 1975;1(5957):561-563.
  19. Foreign bodies in the aerodigestive tract in pediatric patients. Auris Nasus Larynx 2003;30(4):397-401.
  20. Current management of esophageal foreign bodies. Arch Otolaryngol 1981;107(4):249-51.
  21. Magill forceps extraction of upper esophageal coins. J Pediatr Surg 2003;38(2):227-9.
  22. Management of foreign bodies in the esophagus. J Coll hysicians Surg Pak 2004;14(4):218-220.
  23. Foreign body in the oesophagus: review of 2394 cases. Br J Surg 1978;65:5-9.
  24. European Journal of Cardio-thoracic Surgery 31(2007):946-948.
  25. Uber fremdkorperverletzung des oesophagus mitaortenperfora-tion (in German). Berl Klin Wschr 1914;51:7-9.
  26. Silent perforations of the stomach and duodenum by needles. Arch Surg 1978;113:1406-1409.
  27. Management of ingested foreign bodies. In: Hwang NC, Ooi L, editors. Acute Surgical Management. Singapore: World Scientific 2004:171-187.
  28. Esophageal perforation: CT findings. Am J Roentgenol 1993;160:767-770.
  29. Value of helical computed tomography in the management of upper esophageal foreign bodies. Acta Radiol 2004;45:369-374.
  30. Hepatic abscess induced by foreign body: case report and literature review. World J Gastroenterol 2007;13:1466-1470.
  31. Computed tomography and the occult tracheobroncheal foreign body. Radiology 1980; 134:133-135.
  32. [Ingestion of foreign bodies in a prison population; surgical treatment] Spanish. Rev Esp Enferm Apar Dig 1987;72:617-621.
  33. 10th ed. London: Churchill Livingstone: 2003. p. 241-256.
  34. Button batery ingestión: Hazards of esophageal impactation. J Pediatr Surg 1999;34:1527-1531.
  35. Battery ingestions: product accessibility and clinical course. Pediatrics 1985;75(3):469-476.
  36. Button battery ingestion: a solution to a management dilemma. Pediatr Surg Int 1999;15(5):383-384.
  37. Modification of a latex glove for the safe endoscopic removal of a sharp gastric foreign body. Gastrointest Endosc 2000; 52: 127-129.
  38. 980 Letter to the Editor. Successful Management of an Iatrogenically-ingested Sharp Foreign Body. Annals Academy of Medicine 2008;37:980-981.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.