Pediatric Gastroenterology, Hepatology & Nutrition
- Volume 10 Issue 2
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- Pages.147-156
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- 2007
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- 2234-8646(pISSN)
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- 2234-8840(eISSN)
Comparison of Endoscopic Removal of Disk Batteries in Children
디스크 전지를 삼킨 소아에서 내시경적 이물 제거술의 비교
- Kim, Jung-Ok (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Hong, Eun-Hui (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Choe, Byung-Ho (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Cho, Min-Hyun (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Seo, Hye-Eun (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Lim, Hae-Ri (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Chu, Mi-Ae (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Hwang, Su-Kyeong (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Park, Sun-Min (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Hong, Suk-Jin (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Shim, Ye-Jee (Department of Pediatrics, Kyungpook National University School of Medicine) ;
- Choi, Byung-Ho (Department of Pediatrics, Kyungpook National University School of Medicine)
- 김정옥 (경북대학교 의과대학 소아과학교실) ;
- 홍은희 (경북대학교 의과대학 소아과학교실) ;
- 최병호 (경북대학교 의과대학 소아과학교실) ;
- 조민현 (경북대학교 의과대학 소아과학교실) ;
- 서혜은 (경북대학교 의과대학 소아과학교실) ;
- 임해리 (경북대학교 의과대학 소아과학교실) ;
- 추미애 (경북대학교 의과대학 소아과학교실) ;
- 황수경 (경북대학교 의과대학 소아과학교실) ;
- 박선민 (경북대학교 의과대학 소아과학교실) ;
- 홍석진 (경북대학교 의과대학 소아과학교실) ;
- 심예지 (경북대학교 의과대학 소아과학교실) ;
- 최병호 (경북대학교 의과대학 소아과학교실)
- Received : 2007.07.31
- Accepted : 2007.08.30
- Published : 2007.09.30
Abstract
Purpose: Any battery impacted in the esophagus must be removed urgently because of the possibility of serious complications such as perforation, fistula, and mediastinitis. The use of endoscopic procedures was compared to find the most rapid, effective, and safe method to remove disk batteries. Methods: The cases of 24 children (9 males, mean age, 1.5 years) that had accidentally ingested disk batteries were reviewed. The patients had visited the Department of Pediatrics, Kyungpook National University Hospital from July 1997 to June 2007 for the removal of disk batteries. Endoscopic removal was attempted using a retrieval net or a magnetic extractor with a balloon (condom). The procedure times for removing the ingested battery were compared. Results: Children that ingested batteries with a larger diameter (20 mm) had a greater chance to have esophageal impaction with serious injury, such as esophageal mucosal necrosis or ulcers, as compared to the ingestion of smaller diameter batteries (10 mm) (p<0.01). Endoscopic removal of disk batteries was attempted either using a retrieval net in 10 children or by using a magnetic extractor with a balloon in 6 children. Endoscopic removal using a retrieval net was more effective (mean procedure time: 1.5 min) as compared to using a magnetic extractor with a balloon (mean procedure time: 3.3 min) (p<0.05). Conclusion: Both procedures, either using a retrieval net or a magnetic extractor with a balloon were effective in removing ingested disk batteries. Based on our experience, an endoscopic procedure using a retrieval net was a more effective method for foreign body removal.
목 적: 소아에서 디스크 전지를 삼키는 사고가 증가하고 있다. 식도에 걸린 경우 식도 궤양, 천공, 누공, 종격동염 등 심각한 합병증을 유발할 수 있으므로 즉각 제거해야 한다. 본 연구에서는 디스크 전지의 내시경적 제거에 있어서 기구에 따른 제거 속도의 차이와 안전성을 비교해 봄으로써 가장 빠르고 효율적으로 제거할 수 있는 방법을 찾아보고자 하였다. 방 법: 1997년 7월부터 2007년 6월까지 디스크 전지를 삼키고 경북대학교병원 소아과에 내원하여 내시경적 적출술을 시도한 24명의 환아를 대상으로 하였다. 평균 나이는 1.5세였고 남아가 9명이었다. 내시경 보조기구로써 magnetic extractor와 풍선을 이용하거나 retrieval net을 사용한 경우를 별도로 비교하여 제거에 걸린 시간과 안전성에 차이가 있는지 검토하였다. 결 과: 전지의 직경과 두께가