Case 2: Dysphagia to Solid Foods in a 17-month-old Boy
| Autor: | Francis S. Kim, Andrew R. Scott, Jyoti Ramakrishna |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Physical examination 03 medical and health sciences Esophagus 0302 clinical medicine 030225 pediatrics medicine Humans 030212 general & internal medicine Family history Pediatric gastroenterology medicine.diagnostic_test business.industry Infant Foreign Bodies Dysphagia medicine.anatomical_structure Pediatrics Perinatology and Child Health Vomiting Defecation medicine.symptom Deglutition Disorders business Weight gain |
| Zdroj: | Pediatrics In Review. 38:488-489 |
| ISSN: | 1526-3347 0191-9601 |
| DOI: | 10.1542/pir.2016-0232 |
| Popis: | 1. Francis S. Kim, MD, MA* 2. Andrew R. Scott, MD† 3. Jyoti Ramakrishna, MD‡ 1. *Department of Pediatrics, 2. †Division of Pediatric Otolaryngology, and 3. ‡Division of Pediatric Gastroenterology and Nutrition, Tufts Floating Hospital for Children, Boston, MA A former full-term 17-month-old boy is referred to the pediatric gastrointestinal (GI) clinic by his pediatrician for vomiting. He has 4 to 5 episodes weekly of nonbloody, nonbilious emesis after gagging on solid or textured foods. His parents report that he has never been able to eat solid foods but that he swallows liquids and pureed foods easily. His diet consists of whole milk and pureed foods. Bowel movements are normal. He does not have any medical or surgical history, with good growth, development, and weight gain. He does not take any medications and has no allergies. His family history is noncontributory. Physical examination reveals an obese child who is otherwise normal. His initial laboratory evaluation is normal for complete blood cell count with differential count, tissue transglutaminase IgA, and total IgA. Radioallergosorbent test results are low positive for milk at Class 2, which is not clinically significant. A scout radiograph before the upper GI (UGI) series reveals a radiopaque, coinlike, esophageal foreign body (FB) at the thoracic inlet, appearing as a circular disc (en face) on the anteroposterior view (Fig 1A) and as a thick line (en edge) on the lateral view, suggesting that the location is in the esophagus and not in the trachea. Importantly, the FB does not have any features concerning for a button battery, and because it had possibly been present for up to 9 months without any concerning symptoms beyond dysphagia to solid foods, it is removed nonemergently the same day that it is identified. However, owing to the location of the FB, the pediatric otolaryngology department is consulted for removal under general … |
| Databáze: | OpenAIRE |
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