球形食道異物 (ビー玉) 摘出方法の検討
1981 年 24 巻 4 号 p. 445-447,377
詳細
1981 年 24 巻 4 号 p. 445-447,377
The authors report their experience in removal of a glass foreign in the esophagus.
The patient was a 7-year-old girl who visited the hospital 3 weeks after she swallowed the foreign body.
At the initial attempt to remove the foreign body under general anesthesia, the glass ball was lost out of sight. The surgeons presumed that the glass ball had fallen into the stomach.
Roentgenograms taken on the following day, however, showed the glass ball still lodging in the same site.
In the second trial the authors inserted a Foley's balloon catheter beyond the foreign body, then inflated it, preventing the foreign body from falling into the stomach.
The foreign body was then pushed up with the balloon to the level of the second physiological constricture, where it was grasped under direct vision through a Takino's FOT to be removed successfully.
The authors attributed the loss of the foreign body during the initial attempt to the following factors: 1) the surgeons had preconception that a round foreign body at the distal end of the esophagus tends to fall into the stomach, 2) the foreign body was covered with granulation tissue, 3) greater distensensibility of the mucosal walls at the ampulla phrenica and 4) the foreign body located on the right side of the esophagus, off the usual direction of the advancement of the esophagoscope.
