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Acil Servise Başvuran Yabancı Cisim Olgularının Değerlendirilmesi

THE EVALUATION OF FOREIGN BODY ASPIRATION CASES APPLIED TO THE EMERGENCY DEPARTMENT

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Abstract (2. Language): 
Objective: Foreign body (FB) aspirations are mostly seen in infants who like taking objects into their mouth and in preschool children. The diagnosis of FB aspiration was based on history, clinical and radiological findings. In this study, we aimed to evaluate cases of FB aspiration who applied to Dicle University Hospital's Emergency Department between January and December 2000. Method: Patients were evaluated in two groups according to their ages. The first group was the children group (CG), includ¬ing children at 9 years of age or younger; the second group included patients older than 9 years and was called the adult group (AG). Of the 44 patients evaluated, 24 (54.5%) were female and 20 (45.5%) were male (p>0.05). Results: The average ages were 3.4±1.8 (range 1-9) years in CG and 24.3±13.2 (range 14-60) years in AG. 32 patients (72.7%) were in the children group (p=0.003). The most important symptoms were breathlessness and coughing in CG, whereas breathlessness, coughing, abdominal pain and gasping for breathing were the main symptoms in AG. Physical examination revealed unilaterally decreased breathing sounds in 11 patients of CG. Localized foreign bodies (FB) were detected with x-rays in 22 (68.7%) patients of CG and 7 (58.3%) patients of AG. According to localization, the foreign bodies were found mostly in the first narrowing of esophagus (n=20, 45.4%) and secondly, in the right main bronchus (n=13, 29.5%), while 4 of them (9%) were located in the trachea and 3 (6.8%) in the stomach (p<0.0001). The types of FB in our cases were mostly coins in CG (n=18, 56.2%) and sharp bodies in AG (n=9, 75%) (P=0.0001). Conclusion: Consequently, the most swallowed foreign bod¬ies were found to be coins in children so in production, it is necessary to give importance to size of coins in order not to cause aspirations.
Abstract (Original Language): 
Amaç: Yabancı cisim (YC) aspirasyonu, nesneleri ağızlarına götürmeyi seven bebeklerle, oyun çocuklarında daha sık görülür. Tanı, hastanın öyküsü, kliniği ve radyolojik çalışmalar ile konur. Bu çalışmada Dicle Üniversitesi Acil Servisine Ocak-Aralık 2000 döneminde başvuran YC aspirasyonu olgularının değer¬lendirilmesi amaçlandı. Yöntem: Olgular yaşlarına göre iki gruba ayrıldı. Birinci grup <9 yaş çocuk grubu (ÇG); ikinci grup >9 yaş erişkin grubunu (EG) içeriyordu. Değerlendirilen 44 olgunun 24'ü kadın (%54.5), 20'si erkekti (%45.5) (p>0.05). Bulgular: ÇG'nun ortalama yaşı 3.4±1.8 (aralık 1-9) yıl, EG'nun ortalama yaşı 24.3±13.2 (aralık 14-60) yıl idi. 32 (%72.7) olgu çocuk yaş grubundaydı (p=0.003). ÇG'da en önemli semptomlar nefes darlığı ve öksürük idi. EG'nda ise nefes darlığı, öksürük, karın ağrısı ve tıkanma hissi mevcuttu. Olgularımızın; ÇG'nun fizik muayenesinde 11 olguda (%34.3) tek taraflı so¬lunum seslerinde azalma saptandı. Hastaların grafilerinde ÇG'da 22 (%68.7), EG'nda yedi (%58.3) hastada YC saptandı. Lokalizasyonlarına göre YC'ler en çok özofagus birinci darlıkta (n=20, %45.4), ikinci sıklıkta sağ ana bronşta (n=13, %29.5), trakeada (n=4, %9) ve midede (n=3, %6.8) idi (p<0,0001). En sık tespit edilen YC'ler; ÇG'da metal para (n=18, %56.2), EG'ta sivri cisimlerdi (n=9, %75) (p=0.0001). Sonuç: Çocuklarda en sık yutulan YC, metal paradır. Ailelerin bu konuda bilinçlendirilip bu tür YC'leri çocuklardan uzakta tutmaları; metal paraların imalatında, aspirasyona yol açmaya¬cak boyutta olmasına dikkat edilmesi gereklidir.

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Türkiye Aile Hekimliği Dergisi | Turkish Journal of Family Practice | Cilt 7 | Sayı 2 | 2003 |
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