No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
DIFFICULTIES IN DIAGNOSING A FOREIGN BODY IN THE GASTROINTESTINAL TRACT (HYDROGEL) OF A 10-MONTH-OLD CHILD
Abstract
Purpose: informing the doctors who provide aid to children of the peculiarity of the pathology. Methods: a 10-month-old boy who developed recurrent vomiting, cough, nasal discharge and fatigue was admitted to the hospital in his place of residence and diagnosed ARVI with abdominal pain syndrome. In spite of the treatment, the patient’s condition worsened, cerebral edema aggravated, and he received artificial pulmonary ventilation with a diagnosis of acute meningoencephalitis of unclear etiology, cerebral edema, and stage 3 coma. The patient was transferred to the republican hospital where his condition was stabilized using intensive care and correction of water-electrolyte and metabolic disorders. At day 9 after the disease onset, a mobile tumor-like lesion was found on palpation in the right mesogastric region. An abdominal ultrasound showed a round anechogenic lesion with distinct regular outlines (40x40 mm). A surgery was performed to eliminate jejunal obstruction with hydrogel balls. Relaparotomy was done in 6 days. Discussion: this clinical observation shows there are diagnostic difficulties that are unavoidable when a history of peroral intake of hydrogel is lacking. Being in the intestine, hydrogel granules absorbed fluid and their size increased leading to obturation intestinal obstruction. Recurrent vomiting resulted in extrarenal loss of fluid and electrolytes. The patient developed cytotoxic cerebral edema due to hypotonic dehydration. A tumour-like lesion was found on palpation at day 9 after the disease onset. Conclusions: hydrogel balls result in obturation intestinal obstruction with severe water-electrolytic disorders. This pathology requires a surgery with full revision and complete evacuation of foreign bodies from the intestine.
... After reading the full texts or abstracts, we removed reports reporting ear canal obstructions (N ¼ 2), ingestions without bowel obstruction (N ¼ 14), and bowel obstructions not related to the ingestion of superabsorbent polymer-made products (N ¼ 67). Overall, 25 reports reporting 43 cases were considered for analysis: 20 articles with English full-text [3,10,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], three articles with English abstracts but not English full-texts (two in Russian and one in Korean) [32][33][34], and two conference abstracts (one in English and one in French) [5,35]. The first report was published in 2011 [22]. ...
... The first report was published in 2011 [22]. All the included reports were retrospective, including 20 case reports [3,10,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][32][33][34][35] and 4 case series [5,[14][15][16]31]. ...
... Age was available in all reports, except for one case series of 15 patients which provided only the mean age and age range [31] (Table 1). In the reports providing age individually, the median age was 15 months (interquartile range: [10;18]) [3,5,10,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][32][33][34][35]. In the case series, the mean age was 2 years [31]. ...
Rationale
Superabsorbent polymers are marketed as toys, and cases of ingestion in children are increasingly reported. Even if these cases are usually considered benign, bowel obstruction has been reported.
Objective
To investigate the exposure characteristics, clinical presentation, management, and outcome of patients who developed bowel obstruction following ingestion of superabsorbent polymer-made products.
Methods
Databases were searched (no start date − 2020/01/31) using the following keywords: (“superabsorbent” OR "polymer” OR “hydrogel” OR “crystal” OR "jelly" OR “Orbeez” OR "beads") AND (“ingestion” OR “obstruction” OR "perforation") AND (“intestinal” OR “bowel”). All cases of bowel obstruction following superabsorbent polymer-made product ingestion were included.
Results
Report selection: We found 25 reports reporting 43 cases of bowel obstruction following superabsorbent polymer-made product ingestion. All the reports were retrospective, including 20 case reports and 4 case series. Patient characteristics and clinical presentation: Age ranged from 6 to 36 months, and the female/male sex ratio was 1.3. The median delay between the ingestion of the product and the onset of the first symptoms (available in only four reports) was 1.0 [0.7;1.8] day (from 15 h to 2 days). The median delay between the onset of gastrointestinal symptoms and hospital admission, available for all but 15 patients, was 3 [2;4] days (from 15 h to 30 days). The reported symptoms were persistent vomiting in all cases, associated with constipation (11/43), diarrhea (1/43), abdominal pain (1/43), and clinically assessed dehydration (14/43). Abdominal palpation found abdominal tenderness or distension in 11/43 and 28/43 patients, respectively. An abdominal mass was palpated in 3/43 patients. Two patients presented with fever, and three patients developed seizures. Characteristics of exposure: Ingestion of superabsorbent polymer-made products was reported by relatives on hospital admission in only 10/43 cases. Based on imaging and/or surgically/endoscopically removed products, all were bead-shaped objects. The median number of beads removed (available in 27/43) was 1 [1–2] (range from 1 to 6). Their median diameter (available in 21/43 patients) at the time of the diagnosis of bowel obstruction – i.e., at hydrated state – was 30 [30;36] mm (range from 25 to 65 mm). Imaging findings: Abdominal radiography, performed in 31/43 patients, never showed evidence of foreign body ingestion Abdominal computed tomography scanning, performed in 10/43 patients, visualized an intraluminal mass in 5/10 cases. Abdominal ultrasound performed in 34/43 patients allowed visualization of a rounded intraluminal image that corresponded to a bead in 28/34 patients but led to a correct diagnosis of foreign body-induced bowel obstruction in only 15/34 cases. One case reported the contributory use of abdominal MRI. Beads were always located in the small bowel (from the duodenum to the terminal ileum). Removal of beads: Bead removal required endoscopy in 2/43 cases and surgery in 41/43 cases (enterotomy or resection in 36/43 and 5/43 cases, respectively). In 3/36 cases, additional enterotomy was performed to remove beads that had not been found during the first surgery. The delay between the onset of gastrointestinal symptoms and removal procedures ranged from 1 to 7 days. Outcome: Except for two fatal cases, the outcome was favorable.
Conclusions
Ingestion of superabsorbent polymer-made beads can be responsible for fatal bowel obstruction in children related to the increase in bead size within the intestinal tract. Diagnosis is made difficult by the radiolucent properties of the beads. The management of bowel obstruction probably most often requires endoscopic or surgical procedures. Children under 4 years of age are probably the most at risk of developing bowel obstruction.
... (1) e principle of traditional X-ray CT imaging: X-ray CT imaging is an imaging technique that uses certain CT reconstruction algorithms to generate images of the internal structure of the target by measuring the X-rays transmitted through the target [10]. e specific steps of X-ray CT imaging are as follows: First, the continuous X-ray energy spectrum generated in the X-ray tube interacts with the inspected target, and the projection data is generated by analog-to-digital conversion [11,12]; then, a specific CT reconstruction is used and the algorithm calculates the value of the X-ray attenuation factor absorbed by the object being examined. Finally, the calculated X-ray attenuation coefficient value is transmitted to the computer and converted to the corresponding gray value to obtain a CT image of the object to be examined [13]. ...
... Journal of Healthcare Engineering Ax � p. (11) In formula (11), x is the image to be reconstructed. If the system transmission matrix A is invertible, then there is x � A − 1 p. ...
... Journal of Healthcare Engineering Ax � p. (11) In formula (11), x is the image to be reconstructed. If the system transmission matrix A is invertible, then there is x � A − 1 p. ...
A foreign body in the respiratory tract is one of the common accidental injuries of children in our country, and is usually an important and serious event. Injuries caused by foreign substances in the respiratory tract seriously threaten the health and life of children in Korea and are a great challenge for parents as well. In the process of diagnosis of foreign bodies in the respiratory tract, there is often missed diagnosis or serious complications. Therefore, this article proposes the application of 64-slice spiral CT imaging technology based on smart medical augmented reality in the diagnosis of foreign bodies in the respiratory tract in order to improve the diagnosis of foreign bodies in the respiratory tract, provide help with treatment to improve the prognosis of foreign bodies in the respiratory tract, and reduce the incidence of foreign bodies in the respiratory tract. In this paper, 36 children underwent a 64-slice spiral CT scan of their lungs, and images were transferred to a workstation for multiplanar reconstruction, minimal density projection, three-dimensional volume reconstruction imaging, and CT virtual endoscopic reconstruction, the location, shape, size, and size of the foreign body in contrast with adjacent structural lesions and lesions seen during surgery. Experiments have shown that the left bronchial granulation accounted for 27.3%, the right bronchial granulation 18.75%, the main tracheal granulation 28.6%; there was no significant difference between the left and right bronchial granulation (P > 0.05), while the main tracheal granulation and bilateral bronchial granulation there are significant differences between the shape distributions (P
... The direction of the magnetic field of the hydrogen nucleus is not consistent with the direction of the external magnetic field, but always has a certain angle with it and rotates around the external magnetic field like a top. This phenomenon is called precession [6]. The frequency of the hydrogen nucleus precession can be derived from the Lamo equation: ...
In recent years, with the continued development and development of science and technology and the increasing maturity of medical technology, reactive nodular fibrous pseudotumors remain difficult to diagnose. Therefore, this paper studies CT and MRI imaging properties based on hypothetical gastrointestinal and mesangial reactive erythema nodosum fibrous pseudotumors to improve the diagnosis and treatment of reactive nodular fibrous pseudotumors. In this study, 48 patients with gastrointestinal and intermediate-reactive erythema nodosum fibrous pseudotumors in the gastrointestinal tract and experimental group were screened and identified by surgical pathology and immunohistochemistry. CT or magnetic resonance imaging was used in all patients. An analysis is performed, and the diagnostic values are compared with the pathological results. Experiments have proved that the postoperative reexamination of reactive nodular fibrous pseudotumors found that single masses are common, tumor sizes are different, and most small nodules have relatively more uniform lesion density, and the density of the plain scan is close to the muscle density, and the delay can be seen after enhancement. When the mass is large, the density is uniform, and low-density foci of different degrees can be seen in some masses, and this part rarely shows enhancement. The imaging phenomenon and clinical features of reactive nodular fibrous pseudotumors have specific features that distinguish them from invasive tumors such as gastrointestinal stromal tumors and provide an important basis for accurate clinical diagnosis and treatment.
... İnce bağırsakta yutulan yabancı cisimlere bağlı komplikasyon gelişmesi mıknatıslar, keskin cisimler ve piller dışında nadirdir (10) . Ancak, son yıllarda ince bağırsakta tıkanıklığa neden olan yabancı cisimlere SEB de eklenmiştir (4,8,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) . Yutulan SEB'ler gastrointestinal sistemde farinks, özofagus, mide ve piloru kısa sürede büyümeden geçerken ince bağırsakta gastrointestinal sistem salgıları ve alınan sıvılar ile büyümeye devam edip ince bağırsak tıkanıklığına neden olmuşlardır. ...
Objective: Water absorbing beads (WAB), also known as water monkey in Turkey, are popular
foreign bodies and swell when they come in contact with water or water containing solutions. If
ingested, they have potential for causing intestinal obstruction. The aim of the present study is to
compare the results and the differences of WAB ingestion in Turkey and world literature.
Method: Patients who had undergone surgery due to ingestion of WAB were screened, and analyzed using the most used medical databases according to author, year, country, age, sex, time
elapsed from onset of symptoms to admission to hospital, diagnosis and treatment applied.
Results: Twenty-four cases have been reported so far starting from the year 2011 when the first
case operated due to WAB ingestion in the world was published. All of the cases aged ≤ 2 years
and they were operated due to small bowel obstruction. In Turkey, very small number of studies
have been performed related to WAB ingestion and none of the cases have been operated so far.
Conclusion: In Turkey none of the patients underwent surgery due to WAB ingestion, because
nationwide sales of WAB are limited, precautions have been taken. The number of cases are very
scarce because WAB are being used mostly outside the household thus the risk group can not
reach WAB or presumably the cases are not being reported.
Introduction
Cases of ingestion of superabsorbent polymers (SAPs) marketed as ornamental products and toys are increasingly reported.
Objective
The objectives of this study were to describe the trend and outcome of SAPs beads ingestion in France.
Methods
We conducted a retrospective descriptive study over a 10-year period of all cases of SAPs beads ingestion collected by the French Poison Control Centers.
Results
In total, 193 cases of SAPs bead ingestion were collected, 90% of whom among children (median 30 months). More than 75% of cases were asymptomatic while the remaining cases exhibited minor/mild gastrointestinal symptoms. The outcome was spontaneously favorable in all cases except for one fatality in a 18-month-old girl who developed bowel obstruction.
Conclusions
SAPs beads ingestions were mostly asymptomatic but could be responsible for fatal bowel obstruction in children, related to the increase in SAPs beads size within the intestinal tract. The diagnosis was made difficult by SAPs radiolucent properties. SAPs bead ingestion should be considered by practitioners as a possible cause of obstruction with no foreign body found.
Decorative crystal gel balls are used for decoration purpose. Due to their attractive appearance they may be ingested by children. This may result in grave complications. A case of decorative crystal ball ingestion is being reported in a 6 months old infant who presented with sub acute intestinal obstruction and was operated. Crystal gel balls were causing obstruction of jejunum. Enterotomy and removal of the mass of jelly balls was done with primary closure. The patient was re-operated for anastomotic disruption on 6th postoperative day. Baby developed septicemia, and succumbed after 2 days of second operation.
Crystal jelly balls are used for decorative purpose in homes and offices. They swell on contact with water. We managed a patient with a clinical diagnosis of acute abdomen. At surgery, there was fecal peritonitis and three ileal perforations caused by previously ingested decorative crystal balls.
Many of the abdominal foreign bodies are due to accidental ingestion. Our objective in this case report is to emphasize the importance of the enquiry about the foreign body in the differential diagnosis of acute abdominal pain. According to our knowledge, this is the first report of bowel perforation caused by paper ingestion. A 14-year-old boy with abdominal pain underwent exploratory laparotomy and was found to have abdominal pus and ileal perforation. A crumpled paper was found at the site of perforation. Postoperative enquiry revealed that the patient had ingested 10 crumpled papers. We highlight that recording the history is an important aspect in the management of patients with acute abdominal pain and that foreign bodies should be included in its differential diagnosis.
Foreign body ingestion is a common pediatric complaint. Two case reports describe intestinal obstruction in children from an ingestion of a single superabsorbent water ball, requiring surgical removal. We describe nonsurgical management of an asymptomatic child who ingested approximately 100 superabsorbent water beads.Because of the risk for subsequent intestinal obstruction, the patient was admitted for whole bowel irrigation. This case report is the first describing use of whole bowel irrigation in the management of an asymptomatic patient with multiple water beads ingestion.
Foreign body ingestion is a potentially serious clinical problem in children. We report a case of an 8-month-old infant who developed complete bowel obstruction requiring laparotomy due to ingestion of a superabsorbent polymer ball with advertised growth up to 400 times its original size. Most ingested foreign bodies that pass through the pylorus will make it safely through the gastrointestinal tract. This is not true for water-absorbing balls that progressively increase in size and cause intestinal obstruction. Other household products and toys on the market use a similar polymer-based water-absorbing technology, thus increasing the risk for accidental ingestion by young children. These rapidly expanding objects can cause significant morbidity, and timely diagnosis and treatment are prudent to improve patient outcomes.
Acute obstructive intestinal obstruction caused by a foreign body in a 1.5 year old child. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care
- T V Zaitseva
- A V Zolotareva
- R O Ignatiev
- V M Rozinov
Zaitseva T. V., Zolotareva A. V., Ignatiev R. O., Rozinov V. M. Acute obstructive intestinal obstruction caused by a foreign
body in a 1.5 year old child. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(1):55-8.]
(In Russ.)
Severe acute intestinal obstruction caused by hydrogel balls in the practice of resuscitation. Tezisy VI Vserossijskoj konferencii s mezhdunarodnym uchastiem «Neotlozhnaya detskaya hirurgiya i travmatologiya
- Yu V Potaninova
- I F Ostrejkov
- V V Nikitin
Potaninova YU. V., Ostrejkov I. F., Nikitin V. V. Severe acute intestinal obstruction caused by hydrogel balls in the practice
of resuscitation. Tezisy VI Vserossijskoj konferencii s mezhdunarodnym uchastiem «Neotlozhnaya detskaya hirurgiya
i travmatologiya». 15-18 February 2018. M;2018:108. (In Russ.)
Острая обтурационная кишечная непроходимость, вызванная инородным телом у ребенка 1,5 лет. Российский вестник детской хирургии, анестезиологии и реаниматологии
- Т В Зайцева
- А В Золотарева
- Р О Игнатьев
- В М Розинов
Зайцева Т. В., Золотарева А. В., Игнатьев Р. О., Розинов В. М. Острая обтурационная кишечная непроходимость,
вызванная инородным телом у ребенка 1,5 лет. Российский вестник детской хирургии, анестезиологии и реаниматологии. 2017;7(1):55-8.
Nikitin V. V. Severe acute intestinal obstruction caused by hydrogel balls in the practice of resuscitation. Tezisy VI Vserossijskoj konferencii s mezhdunarodnym uchastiem «Neotlozhnaya detskaya hirurgiya i travmatologiya»
- Ю В Потанинова
- И Ф Острейков
- В В Никитин
- Yu V Potaninova
- I F Ostrejkov
Потанинова Ю. В., Острейков И. Ф., Никитин В. В. Тяжелая острая кишечная непроходимость, вызванная ги-дрогелевыми шариками в практике реаниматолога. Тезисы VI Всероссийской конференции с международным
участием «Неотложная детская хирургия и травматология». 15-18 февраля 2018 г. М;2018:108.
Potaninova YU. V., Ostrejkov I. F., Nikitin V. V. Severe acute intestinal obstruction caused by hydrogel balls in the practice
of resuscitation. Tezisy VI Vserossijskoj konferencii s mezhdunarodnym uchastiem «Neotlozhnaya detskaya hirurgiya
i travmatologiya». 15-18 February 2018. M;2018:108. (In Russ.)
SHANGAREEVA Доктор медицинских наук, профессор кафедры детской хирургии с курсом ИДПО Государственного бюджетного образовательного учреждения высшего образования Башкирского государственного медицинского университета Минздрава России
- Шангареева Роза Хурматовна Roza Авторы
- Kh
Авторы
ШАНГАРЕЕВА
Роза Хурматовна
Roza Kh. SHANGAREEVA
Доктор медицинских наук, профессор кафедры детской хирургии с курсом ИДПО
Государственного бюджетного образовательного учреждения высшего образования
Башкирского государственного медицинского университета Минздрава России;
Professor of the Department of Pediatric Surgery with course of IAPE
- Dr
- Sci
Dr. Sci (Med), Professor of the Department of Pediatric Surgery with course of IAPE,
Bashkir State Medical University, Lenin st., 3, Ufa, Russia, 450008, mobile phone:
+7 (917) 365-32-26, E-mail: shanrosa@mail. ru, ORCID -0000-0001-8917-1399
Тяжелая острая кишечная непроходимость, вызванная гидрогелевыми шариками в практике реаниматолога. Тезисы VI Всероссийской конференции с международным участием «Неотложная детская хирургия и травматология
- Ю В Потанинова
- И Ф Острейков
- В В Никитин
Потанинова Ю. В., Острейков И. Ф., Никитин В. В. Тяжелая острая кишечная непроходимость, вызванная гидрогелевыми шариками в практике реаниматолога. Тезисы VI Всероссийской конференции с международным
участием «Неотложная детская хирургия и травматология». 15-18 февраля 2018 г. М;2018:108.