Drink soup while it's hot, but don't be in a hurry! On the sixth day of the Chinese New Year, the 68-year-old Huang Grandma, who was having dinner at home, was too hasty when tasting her own old hot soup, and "swallowed the jujube" accidentally swallowed a jujube core together, and then the neck pain gradually worsened. The family did not dare to be sloppy when they saw the situation, so they quickly took her to the emergency department of the First Affiliated Hospital of Jinan University, and finally underwent surgery to remove the jujube kernel that was about 2.5 centimeters long.
Experts remind that in the digestive tract foreign body treatment carried out by the Digestive Endoscopy Center of the First Affiliated Hospital every year, the elderly and children are mostly elderly, and there are more foreign bodies on holidays than usual. Patients should see a doctor in time when swallowing a foreign body by mistake, and it is strictly forbidden to deal with it themselves, especially to avoid forcibly swallowing the foreign body with rice, steamed buns, leeks and other methods, which is likely to make the foreign body deeper and deeper, resulting in more serious consequences.
Sharp foreign bodies are likely to cause serious consequences, and multidisciplinary consultation escorts them
After Grandma Huang's visit, the medical staff learned that Grandma Huang had a history of chronic diseases such as hypertension and diabetes, and after completing the relevant examinations, the CT results of the neck suggested that the high-density foci in the upper section of Huang's esophagus (about C7 level) were considered for foreign bodies, and the size was about 2.5 cm×0.7 cm. The Emergency Surgery Department and Otolaryngologist immediately contacted The Doctor on Duty at the Digestive Endoscopy Center, Jingwen Liu, to jointly formulate a treatment plan.
Image of a foreign body in the esophagus
Considering that the foreign body stays in the upper part of The esophagus of Grandma Huang, the removal process is more irritating to the throat and can easily cause violent vomiting; the fusiform hard and sharp foreign body is easy to cause bleeding and perforation of the esophagus; and the patient is more elderly women with more underlying diseases, and the foreign body removal process is easy to cause changes in respiratory circulation, and after multidisciplinary consultations such as the emergency department, the Department of Entolaryngology, the Digestive Endoscopy Center and the Department of Anesthesiology of the First Affiliated Hospital, the doctor team decided to give the patient intravenous anesthesia under esophageal foreign body removal. After the medical staff communicated with the patient and his family, and made full preparations and plans, the director of the Department of Anesthesiology, Li Yalan, performed intravenous anesthesia, and then the deputy director of the Digestive Endoscopy Center Zhai Hening performed endoscopic foreign body removal.
A yellow fusiform date nucleus in the upper segment of the esophagus may be seen in the gastroscope as pierced on both sides of the esophagus. Through foreign body forceps visitation, both sides of the foreign body see esophageal mucosal damage, peripheral mucosal congestion and edema, light touch to see the foreign body is not easy to push, consider the foreign body incarceration, but has not yet led to perforation, then use foreign body forceps to clamp the end of the jujube nucleus, Zhai Hening will gently remove the jujube nucleus, the operation procedures are smooth, re-enter the microscope to see local mucosal damage and a small amount of bleeding, no obvious signs of perforation. The crisis is lifted, and the elderly are in danger.
Foreign bodies with digestive tract card are not uncommon during the holidays, and these measures can be prevented
Zhai Hening said that jujube nuclei esophageal foreign bodies have their own characteristics compared with other foreign bodies: sharp ends, easy to cause mucosal damage, bleeding, perforation; large hardness, easy to incarcerated; the surface is smoother, and it is not easy to grasp when using instruments to remove. Such high-risk foreign bodies require multidisciplinary collaboration, supported by intravenous anesthesia, to ensure safe removal.
It is reported that in the digestive tract foreign body treatment carried out by the digestive endoscopy center of the hospital every year, the elderly and children are mostly, and there are more foreign bodies on holidays than usual. Sharp foreign bodies can bring some serious complications, such as bleeding, perforation and infection, and the longer the foreign body is embedded, the greater the probability of complications.
Zhai Hening reminded that patients should be found and treated in time when they swallow foreign bodies by mistake; medical staff need to combine the patient's condition and imaging, multidisciplinary cooperation, and shorten the time for foreign body removal as much as possible.
How to avoid foreign bodies in the digestive tract, the following aspects should be done in life:
1. Eating should not be too hurried, especially when eating food with thorns, bones, and cores, chew it carefully and spit out the bone spurs. Such as fish, chicken, duck, rice dumplings, tangyuan, porridge, etc.;
2. Educate children not to put coins, batteries, magnetic beads, toys, etc. in their mouths or swallow them;
3. It is strictly forbidden to handle it yourself, after swallowing the foreign body by mistake, you should avoid forcibly swallowing the foreign body by means of rice, steamed buns, leeks, etc., which is likely to make the foreign body deeper and deeper;
4. Maintain calm, after the foreign body is stuck, as long as there is no choking cough, difficulty breathing, lips bruising and other suffocation hypoxia manifestations at that time, there is no need to be too nervous;
5. When children play, pay attention to cleaning up the surrounding objects. Pay special attention to whether there are small items on the ground where the baby crawls, such as buttons, pins, paper clips, beans, coins, pills, etc. When eating kernelized fruits, such as dates, hawthorns, oranges, etc., be particularly careful, and the cores should be removed before feeding. Do not feed melon seeds, peanuts, beans and other foods;
6. Mistaken swallowing of sharp objects, sharp tools processing method: if you swallow hard bone spurs, sharp wooden strips, pins, nails, metal sharps, jujube cores, sewing needles and other sharp objects, such items will stab the child's digestive system, a long time into the intestine can lead to perforation, it is recommended to immediately take to the hospital through gastroscopy monitoring to remove;
7. Swallowing unclear liquids, drugs, cosmetics, batteries, etc. should be treated immediately, do not deal with themselves, and provide details to the doctor;
8. Do not induce vomiting, use laxatives, etc., and should be sent to the hospital immediately.
Text, photo/ Guangzhou Daily, Xinhuacheng Reporter: Zhang Qingmei Correspondents: Liu Jingwen, Zhang Cancheng
Guangzhou Daily New Flower City Editor: He Xuehua