RESUMO
The follow up of a 4 1/2 years old boy ingesting a coin shows gastric stagnation of the foreign body. The coin does not pass through the pylorus and upper endoscopy is performed at 6 weeks. No foreign body is visualized but gastric retention is showed by X ray. The coin's extraction is performed after several "biopsy" because mucosal impaction. The patient is now no symptomatic. The anusual complication of coin's ingestion is reported to remember management of this problem.
Assuntos
Corpos Estranhos , Estômago , Pré-Escolar , Corpos Estranhos/patologia , Mucosa Gástrica/patologia , Gastroscopia , Humanos , Masculino , Estômago/patologiaRESUMO
Continuous monitoring of distal oesophageal pH and oesophagoscopy were performed in 28 children aged 15 days to 12 years (mean: 14 months) intubated and ventilated for bronchiolitis (7), pneumonia (8), epiglotitis (2), neurological distress (8), whooping cough (2) or recurrent apneic spells (1). Esophageal pH was studied 2-8 days (mean: 2 days) after intubation; its duration was 12-23 h 50 min (M: 22 h). An abnormal gastroesophageal reflux was presumed when the percent of total monitoring time during which the esophageal pH fell below 4.0 was above 5.2%. The esophagoscopy was carried out on the day following the pH monitoring. All children were in the supine position and fed a pH 7 diet infused continuously with a nasogastric tube; 15 children were under pancuronium. An abnormal gastroesophageal reflux was found in 4 children, associated with a benign esophagitis in 2. A benign esophagitis without gastroesophageal reflux was found in 3 cases. One child had a peptic ulcer of the bulb without gastroesophageal reflux nor oesophagitis. 21 children had no abnormality. Only one of the 15 children under pancuronium had an abnormal gastroesophageal reflux. We conclude that in intubated children fed continuously with a nasogastric tube, gastroesophageal reflux is unfrequent and, when present, appears to have little consequences.