Endoscopy 로 coin 제거 후 발생한 Esophageal stricture
case report
Young Ju Hong M.D., Seonae Ryu, Hye Kyung Chang M.D., Jung Tak Oh M.D., Seok Joo Han M.D.
Department of Pediatric SurgerySeverance Children`s Hospital
Department of SurgeryYonsei University College of Medicine
Background
• Foreign body ingestion– peak : 6 months~ 3years – Evaluate objects by tasting and swallowing them– Foreign body : coin(m/c), toys, batteries, needles, straight pins,
safety pins..– At least 80% : pass the GI system spontaneously– 20% : requires endoscopic intervention– less than 1% : requires surgical intervention– Location : bronchus(m/c), esophagus(2nd m/c), larynx, trachea..
Case – History of illness
• F/1• C.C : dysphagia, drooling• Birth history/ Past history(-/-) IUP 40wks NSVD
Case – History of illness
• EGD : foreign body(coin) removal
Case – History of illness
• F/2 ( 6 months later after EGD foreign body removal)• C.C : vomiting• Esophagography
Case – History of illness
• Balloon dilatation
Case – History of illness
• 1 month later• C.C : vomitng
• 1 month later• C.C : vomiting
Case – History of illness• Esophagography / CT
Case – History of illness• EGD
Case – Operation• Diagnosis
Esophageal stricture
s/p esophageal balloon dilatation
s/p Endoscopic foreign body removal of
esophagus
d/t Foreign body in esophagus(coin)
• Operation Transcervical segmental resection of esophagus
Esophagoesophagostomy(End to End anastomosis)
Case – Operation
Case – Progress• POD 3 : Intubation status with sedative agent• POD 4 : Extubation• POD 7 : SOW• POD 8 : Milk feeding• POD 15 : Esophagography• POD 21 : EGD• POD 23 : discharge
Case – Progress
Case – Progress
Conclusion
• Prevention : best treatment !• Early diagnosis and immediate appropriate treatment
Thank you for your attention !!