The management of oesophageal foreign bodies and their complications

Five patients are described to demonstrate some of the possible clinical courses which may follow the ingestion of a foreign body. The management of such patients is discussed and evidence presented to support the case for detailed investigation, treatment and follow up.     

Foley catheter removal of blunt oesophageal foreign bodies in children

In a two year period between 1985 and 1986, eight children presented with impacted blunt foreign bodies in the oesophagus were successfully treated by removal using a Foley catheter without anaesthesia. There were no complications. All patients were discharged well after one or two days in hospital. The technique is safe, rapid and easy to perform.     

Rectal foreign bodies

We review the histories of 26 patients who were treated at the Royal Perth Hospital for retained rectal foreign bodies. The foreign bodies that were retrieved and the age, sex and marital status of each patient are recorded and a number of the histories is presented. The complications that arose from either the insertion or removal of the foreign body are discussed, as are the methods of treatment that were employed. The various methods that the practitioner has at his disposal for dealing with this increasing problem are reviewed, and a plan of management of patients with non-perforating rectal foreign bodies is suggested.     

Migrating oesophageal foreign body--an unusual case

Ingested foreign bodies which migrate extraluminally are rare occurrences. If untreated, they may result in life threatening complications. Exploration of the neck via an external approach to remove the foreign body is the recommended treatment. The CT Scan utilising fine cuts is invaluable in localising the foreign body for exploration. The case of a patient with a metallic foreign body in the oesophagus which migrated extraluminally is presented. Hemithyroidectomy was required to gain access for removal of the foreign body. A discussion on the management of such a case follows.     

Inhaled foreign bodies in children

We review a series of 115 children who attended the Royal Children's Hospital in Melbourne between 1979 and 1982 with the diagnosis of inhalation of a foreign body, or in whom a foreign body was found at bronchoscopy. Children between the ages of one and three years were the most commonly affected (75%) and boys outnumbered girls in the ratio 3:2. In 16% of cases the child did not present until more than one week after inhaling the foreign body. A peanut was the most common foreign body found (52% of cases), and it seems that many parents are still unaware that peanut ingestion can be hazardous in very young children.     

气管支气管异物的诊疗体会

目的探讨气管支气管异物的诊断方法和治疗效果。方法分析143例气管支气管异物患者的诊断和治疗效果,试验组83例经肺部螺旋CT及三维重建诊断后,采用全麻及术前甲基泼尼松龙静脉注射;对照组60例经胸部X线或普通CT检查诊断后,采用全麻及术前地塞米松静注,经支气管镜取出异物。结果试验组83例气管支气管异物病例,均一次性成功取出,无新的并发症发生。对照组60例中47例全麻下经支气管镜成功取出异物,其中35例均一次性手术成功取出异物,12例经过二次手术取出,治愈47例,13例无异物,10例出现新的并发症。结论早期采取有效的诊断方法,提高术前诊断阳性率;全麻术前使用甲基泼尼松龙,是提高气管支气管异物治愈率,降低并发症和病死率的有效手段。     

小儿呼吸道异物治疗846例

目的探讨小儿呼吸道异物的最佳治疗方法。方法对呼吸道异物患儿846例中的827例,急诊全麻下行支气管镜检查术及异物取出术,感染较重或合并皮下气肿气胸19例患儿先行对症消炎后再行手术。结果846例中一次手术成功率为99.53%（842/846）,4例一般情况不良,行支持消炎治疗后二次手术成功。无1例气管切开、开胸、死亡病例。结论小儿呼吸道异物的取出要选择最佳的手术时机和麻醉方法,诊治及时,可获得较好疗效。