Endoscopy 로 coin 제거 후 발생한 Esophageal stricture case report

1. Endoscopy로 coin제거 후 발생한Esophageal stricturecase report Young Ju Hong M.D., SeonaeRyu, Hye Kyung Chang M.D., Jung Tak Oh M.D., SeokJoo Han M.D. Department of Pediatric Surgery Severance Children`s Hospital Department of Surgery Yonsei University College of Medicine

2. 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..

3. Case – History of illness • F/1 • C.C : dysphagia, drooling • Birth history/ Past history(-/-) IUP 40wks NSVD

4. Case – History of illness • EGD : foreign body(coin) removal

5. Case – History of illness • F/2 ( 6 months later after EGD foreign body removal) • C.C : vomiting • Esophagography

7. Case – History of illness • Balloon dilatation

8. Case – History of illness • 1 month later • C.C : vomitng • 1 month later • C.C : vomiting

9. Case – History of illness • Esophagography / CT

10. Case – History of illness • EGD

11. 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)

12. Case – Operation

13. 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

14. Case – Progress

15. Case – Progress

17. Conclusion • Prevention : best treatment ! • Early diagnosis and immediate appropriate treatment

18. Thank you for your attention !!