원저 : 생선 가시로 응급실을 방문한 인두 이물 소아 환자에게 단순 방사선 촬영이 유용한가?
분야
의약학 > 외과학
저자
정혜진 ( Hea Jin Chung ) , 곽영호 ( Young Ho Kwak ) , 김도균 ( Do Kyun Kim ) , 정재윤 ( Jae Yun Jung ) , 이진희 ( Jin Hee Lee ) , 김한범 ( Hahn Bom Kim )
발행기관
대한응급의학회
간행물정보
대한응급의학회지 2012년, 제23권 제4호, 537~542페이지(총6페이지)
파일형식
18402490.pdf [무료 PDF 뷰어 다운로드]
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    영문초록
    Purpose: This study was conducted in order to identify the clinical characteristics of fish bone impaction among children in three tertiary hospitals and to investigate the usefulness of plain radiographs. Methods: Children with suspected fish bone impaction in their aerodigestive tract were enrolled in this study. Data on patient`s sex and age, characteristics of the allegedly ingested fish bone, utilization rate and result of neck radiographs, and removal procedures were collected retrospectively from three university-affiliated hospitals. Results: A total of 270 children, from Seoul National University College of Medicine (n=113), Seoul National University Bundang Hospital (n=114), and Seoul National University Boramae Hospital (n=43) were enrolled consecutively. A total of 162 patients (60.0%) were male; the mean age of subjects was 6.9±4.1 years. The most commonly suspected source of fish bones was mackerel (n=58, 21.5%), followed by yellow corbina (n=57, 21.1%), and cutlass fish (n=22, 8.2%). Results of initial oropharyngeal inspections by emergency physicians (EP) were negative in 213 patients (78.9%). Among these patients, 173(64.1%) underwent simple neck radiography (radiograph group) and 40(14.8%) patients did not (non-radiograph group). In the radiograph group, no fish bone (0.0%) was observed on plain radiographs. Additional throat examinations were consulted to otolaryngologists (OL), and fish bones were detected in 62(35.8%) and 15(37.5%) patients, from the radiograph group and non-radio group, respectively. Among oropharyngeal inspections performed by EP or OL (130 patients), the most common impacted site of fish bones was the paratonsillar area (n=92, 71.5%). Conclusion: Mackerel and corbina are common sources of fish bone impaction in Korean children. Due to poor visualization and no additional information for use in management, the usefulness of plain radiographs is questionable.
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