막대자석 14개를 삼킨 12세 자폐아: 위내시경과 대장내시경을 이용한 단계적 배출
A Case of Magnet Ingestion in a Child with Autism: Gastro-Colonoscopic Removal without Surgical Complication
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
With the increasing use of magnets in toys, magnet ingestion is becoming a serious problem in children. Two or more magnets may attract across the gastrointestinal tract leading to pressure necrosis, perforation, fistula, volvulus or obstruction. We report a case of a 12-year-old boy with autism who presented with vomiting during seven days due to ingestion of 14 magnetic rods. Under general anesthesia, 5 of 14 magnets were removed from the second portion of the duodenum using a magnetic probe during endoscopy. The remaining magnets were not visible in the duodenum. A plain radiograph taken the next day revealed that the remaining magnets were impacted in the descending-sigmoid junction. One magnet passed spontaneously. However the other 8 magnets did not pass through the junction for 7 days. Five of 8 impacted magnets were removed by a colonoscopic procedure. After 2 hours of colonoscopy, one by one, the remaining three magnets spontaneously passed. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 299∼304)
Abstract
With the increasing use of magnets in toys, magnet ingestion is becoming a serious problem in children. Two or more magnets may attract across the gastrointestinal tract leading to pressure necrosis, perforation, fistula, volvulus or obstruction. We report a case of a 12-year-old boy with autism who presented with vomiting during seven days due to ingestion of 14 magnetic rods. Under general anesthesia, 5 of 14 magnets were removed from the second portion of the duodenum using a magnetic probe during endoscopy. The remaining magnets were not visible in the duodenum. A plain radiograph taken the next day revealed that the remaining magnets were impacted in the descending-sigmoid junction. One magnet passed spontaneously. However the other 8 magnets did not pass through the junction for 7 days. Five of 8 impacted magnets were removed by a colonoscopic procedure. After 2 hours of colonoscopy, one by one, the remaining three magnets spontaneously passed. (Korean J Pediatr Gastroenterol Nutr 2011; 14: 299∼304)
참고문헌 (17)
- "Centers for Disease Control and Prevention. Gastrointestinal injuries from magnet ingestion in children – United States, 2003-2006", MMWR Morb Mortal Wkly, 55, pp.1296~1300 (2006)
- Lee WH, "A case of gastroduodenal fistula caused by ingested magnetic foreign bodeis", Korean J Pdiatr Gstroenterol Nutr, 11, pp.84~88 (2008)
- 곽병곤, "삼킨 목걸이 자석으로 인해 발생한 소장-장간막-소장 누공 1례", Pediatric Gastroenterology, Hepatology & Nutrition, 8(1), pp.60~63 (2005), 대한소아소화기영양학회
- 김미정, "팔찌자석 3개를 삼킨 후 동반된 위궤양 1례", Pediatric Gastroenterology, Hepatology & Nutrition, 5(1), pp.68~72 (2002), 대한소아소화기영양학회
- Seo JK, "Endoscopic management of gastrointestinal foreign bodies in children", Indian J Pedatr, 66(1), pp.75~80 (1999)
- Ohno Y, "Gastroduodenal fistula caused by ingested magnets", Gastrointest Endosc, 61, pp.109~110 (2005)
- Seo JK, "Endoscopic management of gastrointestinal foreign bodies in children:a clinical practice guideline", Korean J Pediatr Gastroenterol Nutr, 10(1), pp.64~79 (2007)
- Hwang JB, "How strong construction toy magnets are! A gastro-gastro- duodenal fistula formation", J Pediatr Gastroenterol Nutr, 44, pp.291~292 (2007)
- Chung JH, "Small bowel complication caused by magnetic foreign body ingestion of children", J Pediatr Surg, 38, pp.1548~1550 (2003)
- Cauchi JA, "Multiple magnet ingestion and gastrointestinal morbidity", Arch Dis Child, 87, pp.539~540 (2002)
- Kubota Y, "Intestinal obstruction in an infant due to magnet ingestion", Eur J Pediatr Surg, 5, pp.119~120 (1995)
- Nui A, "An intestinal volvulus caused by multiple magnet ingestion: an unexpected risk in children", J Pediatr Surg, 40, pp.9~11 (2005)
- 장연수, "자석 이물질 섭취 후 발생한 회장 천공", 대한외과학회지, 76(4), pp.270~272 (2009), 대한외과학회
- Shah SK, "Intestinal complications of magnet ingestion in children from the pediatric surgery perspective", Eur J Pediatr Surg, 19, pp.328~340 (2009)
- "Canadian Paediatric Surveillance Program. Magnets in the bowel: a sticky problem", Paediatr Child Health, 13, pp.118~ (2008)
- Lake JP, "Management of retained colorectal foreign bodies: predictors of operative intervention", Dis Colon Rectum, 47, pp.1694~1698 (2004)
- Saeed A, "Attraction problems following magnet ingestion", Ann R Coll Surg Engl, 91, pp.10~12 (2009)