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5.
J Pediatr Surg ; 42(3): E13-6, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17336176

RESUMO

Accidental ingestion of foreign bodies is a common problem in children, but ingestion of magnets is rare. When multiple magnets are ingested, they may attract each other through the intestinal walls, causing pressure necrosis, perforation, fistula formation, or intestinal obstruction; as has been reported in 13 cases in the past 10 years. We report the fifth case in the literature of intestinal perforation and fistula caused by the ingestion of 2 small magnetic pieces of a toy by a 3-year-old boy. We find it necessary that sanitary authorities give more information to parents and physicians about the potential risks of these magnetic toys.


Assuntos
Corpos Estranhos , Doenças do Íleo/etiologia , Perfuração Intestinal/etiologia , Magnetismo/efeitos adversos , Jogos e Brinquedos/lesões , Pré-Escolar , Humanos , Doenças do Íleo/diagnóstico por imagem , Doenças do Íleo/cirurgia , Perfuração Intestinal/diagnóstico por imagem , Perfuração Intestinal/cirurgia , Masculino , Radiografia
6.
J Pediatr Surg ; 41(11): 1870-3, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17101361

RESUMO

PURPOSE: Recurrent tracheoesophageal fistula (RTF) is a serious common complication of the surgical treatment of esophageal atresia. We report the results of our technique of bronchoscopic treatment of RTF with fibrin glue (Tissucol), with a follow-up of over 1 decade. METHODS: A retrospective review between 1993 and 2004 was conducted, including all patients diagnosed with RTF and treated bronchoscopically with Tissucol, with over 1 year of follow-up. The procedure was implemented under general anesthesia using a rigid neonatal bronchoscope. A magnification chamber and previous diathermia using a urethral catheter were used in the latter 4 patients. The fibrin glue was injected through a clear catheter. The number of endoscopic sessions per patient was limited to 3. RESULTS: Seven patients were treated, with evidence of fistular closure in 6 (85%). One patient with satisfactory results, but a follow-up of 4 months, was not included. The age at bronchoscopy ranged from 14 to 20 days (mean, 16.7 days), and a total of 12 sessions were required (mean, 1.7). In the latter 4 patients, diathermia was associated with good results in all and a lower number of sessions (mean, 1.5). All patients were evaluated clinically and radiologically, and a control endoscopy was performed in 4 patients. The follow-up lasted from 2 to 11 years (mean, 7.4 years). CONCLUSIONS: Because we started to use Tissucol (1994), other authors have reported successful isolated cases, but a relatively large series and a long-term follow-up were lacking. We consider that the success of the procedure depends on several technical factors such as an early diagnosis, before epithelium is formed in the fistula, and the use of initial diathermia, associated in the latter 4 patients. The results obtained with 85% success with a follow-up over 1 year show that the fibrin adhesive is the reference substance for the treatment of RTF; we recommend its endoscopic application associated with diathermia as initial measure.


Assuntos
Broncoscopia , Eletrocoagulação , Adesivo Tecidual de Fibrina/administração & dosagem , Adesivos Teciduais/administração & dosagem , Fístula Traqueoesofágica/terapia , Seguimentos , Humanos , Recém-Nascido , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Fístula Traqueoesofágica/cirurgia , Resultado do Tratamento
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