Çakmak said, “There are children whose esophagus we remove concrete nails, iron screws, coins. In fact, a 1-year-old patient swallowed a huge bracelet, which we were amazed at how it went down his esophagus. Families must be very careful are with children in this age range. The most dangerous are coin-shaped disc batteries. Because they can cause burns and perforations in the esophagus and trachea due to their alkaline nature,” he said.
“OBJECTS LEAKING INTO THE RESPIRATORY PIPE CREATE A DANGER TO LIFE”
Dr. Çakmak pointed out that events related to foreign body ingestion sometimes occur in the digestive tract and sometimes in the respiratory tract. This is because children put everything in their mouths for teething, itching or the desire to discover or taste something. While some of the foreign bodies escape into the digestive tract i.e. the esophagus, some escape into the respiratory tract i.e. the trachea. Objects escaping into the digestive tract are relatively harmless, but foreign objects escaping into the respiratory tract can be life-threatening and unfortunately we can lose a significant number of patients at that point. We encounter very interesting foreign bodies. Children surprise us more and more. For example, from the shoe zipper to the concrete nail used in construction, I removed 2 concrete nails from a child’s airway. The ring, even a 1-year-old boy, swallowed a huge bracelet, which we were amazed how even passed through his esophagus. Thank goodness he got it with feces. Of course there are also children who swallow pins,” he said.
“DO NOT WEAR Amber NECKLACE, BABY SIGHT GOLD”
Explain that the amber necklaces worn during teething, which are very common in our society, especially during childhood, or the jewelry attached to the collar with safety pins when you go to a baby, objects such as gold are very risky . Çakmak continued his words as follows: “These are places where the child can easily reach. Once the child throws his hand, he can break that chain and swallow the pieces or aspirate them into the airways. Likewise, if jewelry is attached, the safety pin is very dangerous for us. Safety pins can pierce the esophagus. Because the boy puts it in his mouth as he takes it.”
“Sometimes it goes unnoticed for weeks”
Noting that children with foreign bodies in the airways are usually taken to hospital with severe respiratory distress, Opr. Dr. Mehmet Çakmak: “In some late cases, there is a chronic cough for which the cause cannot be found. Sometimes, even after 1 month, there are patients who are noticed on an X-ray and sent to us. Some objects may not be visible on X-rays. It must be radiopaque material to be visible on an X-ray. In such cases, we make direct bronchoscopy. Because the child has severe respiratory distress and a severe decrease in oxygen saturation. In bronchoscopy, we put the child to sleep under general anesthesia, enter the airway with an iron tube called a small finger-thick rigid bronchoscope, move it with a camera, and remove the object with forceps. Of course, this process is not so innocent. During the procedure, there may be a picture called bronchospasm, which anesthesiologists are very afraid of. In the meantime, the child’s oxygen saturation may drop to zero. We have to interrupt the process, we may have to make additional interventions. It’s a life-threatening situation,” he said.
“WE ARE MOST ENCOUNTERED WITH METAL MONEY SWALLOW”
Dr. Dr. Çakmak continued his words as follows: “The child can put whatever he finds in his mouth to taste or examine. For example, after the age of 2, nutty foods can be voluntarily given to the child by the families. If the chewing habit is not fully learned in the child, they can get into the trachea. When swallowing a foreign body, the most common thing we come across is swallowing coins, which is one of the easily accessible things in the house. Usually the coin hides in the first stenosis of the esophagus. Such patients cannot even swallow their saliva, they cannot eat, they are brought to us with this complaint. Since we are located in a well-connected neighborhood, we can easily get money from the food route. However, we do not intervene on foreign objects that fall into the stomach or end up in the intestine. We have a wait and see policy. Because the narrowest part of the gastrointestinal tract, that is, from the mouth to the anus, is the first stenosis of the esophagus. Any object that passes through here can be expelled (with stool) through the anus.
“BIGGEST RISK DISK BATTERIES”
Emphasizing that the greatest risk of ingestion of foreign objects is the disc batteries, which are also commonly used in toys, Dr. Çakmak concluded as follows: “Disk batteries can cause alkaline burns in the esophagus. These are very dangerous. These are the foreign body cases that we are very afraid of. Disk batteries can burn and puncture the esophagus in a matter of hours, and even burn the airways and cause alkaline burns. Regardless of the part of the esophagus, it should be removed as soon as possible. This is one of our most urgent cases. But when it falls into the stomach, the alkali is neutralized by the action of stomach acid and does not cause any problems. Sometimes there is a risk of an obstruction in the area we call the pylorus at the exit of the stomach, of course we intervene endoscopically.”