Young Ju Hong M.D., Seonae Ryu, Hye Kyung Chang M.D., Jung Tak Oh M.D., Seok Joo Han M.D. Department of Pediatric Surgery Severance Children`s Hospital.

Endoscopy 로 coin 제거 후 발생한 Esophageal stricture

case report

Young Ju Hong M.D., Seonae Ryu, Hye Kyung Chang M.D., Jung Tak Oh M.D., Seok Joo Han M.D.

Department of Pediatric SurgerySeverance Children`s Hospital

Department of SurgeryYonsei University College of Medicine

Background

• Foreign body ingestion– peak : 6 months~ 3years – Evaluate objects by tasting and swallowing them– Foreign body : coin(m/c), toys, batteries, needles, straight pins,

safety pins..– At least 80% : pass the GI system spontaneously– 20% : requires endoscopic intervention– less than 1% : requires surgical intervention– Location : bronchus(m/c), esophagus(2nd m/c), larynx, trachea..

Case – History of illness

• F/1• C.C : dysphagia, drooling• Birth history/ Past history(-/-) IUP 40wks NSVD

Case – History of illness

• EGD : foreign body(coin) removal

Case – History of illness

• F/2 ( 6 months later after EGD foreign body removal)• C.C : vomiting• Esophagography

Case – History of illness

• Balloon dilatation

Case – History of illness

• 1 month later• C.C : vomitng

• 1 month later• C.C : vomiting

Case – History of illness• Esophagography / CT

Case – History of illness• EGD

Case – Operation• Diagnosis

Esophageal stricture

s/p esophageal balloon dilatation

s/p Endoscopic foreign body removal of

esophagus

d/t Foreign body in esophagus(coin)

• Operation Transcervical segmental resection of esophagus

Esophagoesophagostomy(End to End anastomosis)

Case – Operation

Case – Progress• POD 3 : Intubation status with sedative agent• POD 4 : Extubation• POD 7 : SOW• POD 8 : Milk feeding• POD 15 : Esophagography• POD 21 : EGD• POD 23 : discharge

Case – Progress

Case – Progress

Conclusion

• Prevention : best treatment !• Early diagnosis and immediate appropriate treatment

Thank you for your attention !!