At about 22:00 on February 21, a 9-month-old baby girl came to our hospital (the first affiliated hospital of Shihezi University School of Medicine) for "6 hours by mistake" for "taking animal bones by mistake". The medical staff immediately performed a CT examination of the esophagus, and the results suggested that nodular isometric shadows were seen in the esophageal cavity, and foreign bodies in the esophagus were considered. Subsequently, the child was urgently admitted to the pediatric ward and planned to undergo emergency endoscopic gastrointestinal foreign body removal.
After emergency consultations with multidisciplinary experts in gastroenterology, anesthesiology, endoscopy center, operating room, etc., a treatment plan was formulated for the child. Considering that the child is only 9 months old and cannot cooperate with the operation, the operation must be performed under general anesthesia. Because such surgeries require oral gastrososcopy, they may directly lead to blockages in the throat or irritation of the child's throat, resulting in increased oral secretions and thus blockage of the airway. To ensure airway patency during surgery, endotracheal intubation is routinely required. However, the airway of 9-month-old infants is not fully developed, and intubation may lead to complications such as airway damage, laryngeal spasm, and bronchospasm. At the same time, for infants whose organs are not fully developed, the combination of "sedation, analgesia, muscle relaxation" and other general anesthesia drugs should be avoided as much as possible. Coupled with the fact that esophageal foreign body removal takes a short time, endotracheal intubation is not the best option. After much thought, Dr. Fan Shiwen of the Department of Anesthesiology decided to perform general anesthesia without intubation for the child.
In the end, Dr. Fan Shiwen of the Department of Anesthesiology completed the anesthesia of the entire operation with the drug that had the least impact on the baby under the premise of meeting the depth of anesthesia required for the operation, and the baby always retained spontaneous breathing and stable vital signs.
At 2:40 on February 22, with the joint efforts of gastroenterologists Tang Ming and Peng Xin and li Li, nurses of the Endoscopy Center, the bones stuck in the upper middle and upper part of the baby's esophagus with a diameter of about 2 cm were successfully removed, and no obvious esophageal damage was seen, and everyone was relieved.
The child's father holds the awakened baby in his arms, his eyes are moist, and his mouth constantly says "thank you, thank you, thank you" in his mouth. All the medical staff present were very relieved and hoped that the baby would grow up safely and healthily from now on and never suffer such a long time again.
An affiliated hospital expert reminds: exploration, curiosity is the nature of children, in the age of 3 months to 2 years old, is the child's growth process of the oral period, is a process of using the mouth to explore the world, parents need to always be vigilant about the child's behavior, especially sharp objects do not place in the child's "vision range".
Between 6 months and 6 years of age, the age group of high incidence of foreign bodies in the digestive tract is common, and the foreign bodies swallowed are: coins, small toys, jewelry, buttons, fruit cores, animal bones, magnets, batteries or large pieces of food, etc., and even only you can't think of anything, there is nothing he can't swallow.
Popular science trivia
Esophageal foreign body is one of the common emergency departments, often due to careless diet, mispharyngeal foreign bodies such as fish bones, jujube nuclei, bones, etc., resulting in foreign bodies temporarily staying in the throat or narrow parts such as the entrance of the esophagus, which can block the airways when serious, cause suffocation, and may also cause serious consequences such as esophageal perforation.
Foreign bodies in the esophagus of children may manifest as dysphagia, difficulty eating, vomiting, and crying. After the foreign body is embedded, it is not advisable to forcibly swallow the rice ball, steamed bun, vinegar, etc. to try to swallow the foreign body, parents can not have a fluke mentality, need to go to the local regular hospital immediately, such as delay in diagnosis and treatment, may lead to serious consequences, and may even endanger life.
Pediatric esophageal foreign body, the emphasis is on defense. Because children are naïve and curious, like to take objects into the mouth, because the defense reflex is not sound and mistakenly swallowed into the esophagus or choked into the trachea, usually parents should pay attention to avoid giving children coins, buttons, micro batteries, plastic covers, bones, small parts toys, etc., in addition, parents should also avoid children crying when eating, laughing, and competing with each other, etc., to prevent the occurrence of accidental swallowing of items.
The First Affiliated Hospital of Shihezi University School of Medicine