동전을 삼킨 소아환자의 임상적 고찰을 통한 처치 계획

Coins are the most common esophageal foreign body in children. We performed this study to determine a therapeutic plan for coin ingestion in children. We retrospectively reviewed the charts and radiographs of 87 coin-ingestion patients treatead at university hospital from June 1994 to February 1998. In addition, information was collected from telephone interview. The patients age of the patients was 52.8 ±29.4 months. Fifty-two patients (63.2%) were male. There were 63 (70.1%) children with an esophageal (61 cases) or a pharyngeal (2 cases) coin. The remaining 24 (29.1%) children passed the coin from the esophagus to the stomach. Of the 87 ingested coins, 45 were 100 Won, 20 were 10 Won, 11 were 50 Won, 10 were 500 Won, and 1 was unknown. Endoscopy was performed in 57 cases with 1 esophageal perforation. The Foley catheter method of coin extraction was attempted in that 1 case and was successful without com-plication. Twenty -one of the coins passed spontaneously without complication. The average time of spontaneous passage were 5.5 ±5.5 days (maximum of 22 days). These results suggest that all children who swallow coins should have roentgenograms taken to determine the loca-tion. Coins that lodge in the esophagus may cause several serious complications. Esophageal, except lower esophageal coins, coins should be removed promptly. If the coin passes to the stomach it will generally pass through the remainder of gastrointestinal tract without complica-tion. Therefore, all children who have coins in their stomaches should be observed until the coins passed through the anus.