OBJECTIVETo study the diagnosis and treatment of gastrointestinal injury caused by magnetic foreign body ingestions in children.

METHODSA literature search was performed to identify all the studies related to gastrointestinal tract injury caused by ingesting magnetic foreign body using databases including Google, Medline, ISI Web of Knowledge, Ovid, Wanfang data, VIP, CNKI, degree dissertation, meeting abstracts, and request for document delivery. Language was limited to English, Chinese, Japanese, and Korean. Parameters studies were age at diagnosis, gender, country, regional distribution, number of magnetic foreign bodies, source of magnetic foreign bodies, clinical features, diagnosis, and method for foreign body removal.

RESULTSA total of 98 cases of magnet ingestion were identified from 17 countries and regions. There were 94 patients under the age of 18, with most children younger than 5 years old(62.2%,61/98). The age at peak incidence was 3 years old (16.3%, 16/98). Magnetic foreign bodies ingested included toys(74.5%), medical apparatus(8.2%), accessories(4.1%), and others(6.2%). The number of bodies ranged from 2 to 100. Eleven (11.2%) patients were complicated with allotriophagia or autism. Delay diagnosis and treatment existed in all the patients to varying extents, of whom one died from severe infection. Exploratory laparotomy showed a wide range of bowel damage from the esophagus to the colon, including perforation and intestinal fistula. Intestinal damage was the most common injury (51.0%), followed by intestine-colon fistula (15.3%). All the patients required bowel resection with anastomosis or fistula repair except for 2 children who were managed by endoscopic removal of the foreign bodies.

CONCLUSIONIngesting more than one magnet will lead to severe gastrointestinal injury. Early diagnosis and surgical intervention are important. More precautious measures should be taken for children aged younger than 5 years old.

Adolescent ; Child ; Child, Preschool ; Foreign Bodies ; Gastrointestinal Tract ; injuries ; Humans ; Magnetics

Enterococcus is a gram positive coccus and a normal flora in gastrointestinal tract, but it could raise opportunistic infection. In 1986, vancomycin resistant enterococcus(VRE) was reported in Europe at first. Recently, the incidence is increasing in USA and Korea(2~8%). In our hospital, sore and stool cultures for enterococcal identification were carried out on 4 patients with sore wound. By screening stool culture, VRE was detected in 3 of 4 pressure sore patients. VRE was also identified from the sore wound in 2 of 3 patients who had VRE positive in screening stool culture. 2 of 4, enterococcal positive patients, have the history of vancomycin use in the past. An increasing number of VRE infection in hospital suggest that VRE become an important cause of infected pressure sore. Therefore, culture of sore wound and stool for the identification of VRE should be performed routinely.
Enterococcus ; Europe ; Gastrointestinal Tract ; Humans ; Incidence ; Mass Screening ; Opportunistic Infections ; Pressure Ulcer ; Vancomycin ; Wounds and Injuries*

BACKGROUND: Foreign objects in the gastrointestinal tract are usually the result of accidental swallowing. Yet foreign object ingestion is often seen in prisoners who mainly desire to leave prison. We report here on a series of 33 Korean prisoners with foreign object ingestion and they were treated endoscopically or surgically. METHDOS: We reviewed the medical records of 33 Korean prisoners (52 episodes) who were admitted due to ingestion of foreign objects between January 1998 and June 2004 to Konyang University Hospital and Gyeongsang National University Hospital. RESULTS: All the patients were male with a mean age of 35 years. The most common duration from ingestion to the visit to the ER was within 24 hours (25/52 episodes). Most of the foreign objects were located in the esophagus (42.3%) and stomach (42.3%). The number of foreign objects was one in 28 episodes, two in 12 episodes and three or more in twelve episodes. The most common foreign objects were metal wires (26/52 episodes). The mean size of the foreign objects was 11.9 centimeters long. Successful endoscopic treatment was performed in most patients (46/52 episodes, 88.5%). The remaining six cases were treated surgically. CONCLUSIONS: The foreign objects in prisoners were a variety of unusual things because of the prison environment, and endoscopy is a mainstay of treatment for foreign object removal in Korean prisoners.
Accidents ; Adult ; *Deglutition ; *Endoscopy, Gastrointestinal ; Foreign Bodies/*surgery ; Foreign-Body Migration/complications/*surgery ; Gastrointestinal Tract/*injuries ; Humans ; Korea ; Male ; *Prisoners ; *Prisons ; Risk Factors

The angiotensin I converting enzyme inhibitor (Captopril) has recently been studied extensively in various experimental models of radiation injury and has proven its protective effects in various organs, such as the lungs, gastrointestinal tract, and kidneys. Twenty-three Sprague-Dawley rats were divided into experimental and control group. The experimental group was divided into two large groups: the first one received a single dose of 18 Gy irradiation from an electron beam on the local field of the kidney region only, and the second group received captopril per oral continuously after the same doses of irradiation. The second experimental group was divided into four subgroups by captopril doses: 62.5 mg/l, 125 mg/l, 250 mg/l, and 500 mg/l, respectively. On light and electron microscopy, the kidneys of the irradiated rats with no captopril treatment showed diffuse glomerular contraction, congestion with occlusion and focal necrosis of the endothelial, and mesangial cells. The tubules showed ballooning degeneration, desquamation, and diffuse coagulation necrosis. Captopril treated rats, especially those given a high dose (more than 250 gm/l), revealed a marked reduction of the tubular and glomerular injuries. There was a statistically significant difference in the degree of renal injury among the experimental groups (p<0.05). The result of this study suggests that an administration of high dose captopril might prevent radiation-induced renal injury, especially in the early post-irradiation period.
Animals ; Captopril* ; Estrogens, Conjugated (USP) ; Gastrointestinal Tract ; Kidney ; Lung ; Mesangial Cells ; Microscopy, Electron ; Models, Theoretical ; Necrosis ; Peptidyl-Dipeptidase A ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns, Chemical ; etiology ; nursing ; Female ; Gastrointestinal Tract ; injuries ; Humans ; Male ; Middle Aged ; Peracetic Acid ; adverse effects ; Young Adult

BACKGROUNDDuring cardiac arrest, the gastrointestinal tract is sensitive to ischemia. Protection of the gastrointestinal tract is a critical factor in determining prognosis following cardiopulmonary resuscitation (CPR). This study seeks to determine the extent of gastrointestinal tract injury and the potential protective effect of inducing hypothermia following a porcine cardiac arrest model and CPR.

METHODSVentricular fibrillation was induced by programmed electrical stimulation in 16 male domestic pigs (n = 8 per group). Four minutes after ventricular fibrillation, CPR was performed. Pigs that successfully restored spontaneous circulation then received intravenous infusions of saline at either 4°C or room temperature to produce hypothermic and control conditions respectively. Serum diamine oxidase and gastrointestinal adenosine triphosphate enzyme activity were determined and histopathology of the gastrointestinal tract was performed by light microscopy and electron microscopy.

RESULTSSignificant injury of the gastrointestinal tract after CPR was found. Na(+)-K(+) and Ca(2+) adenosine triphosphate enzyme activity in the gastric tissue were significantly high in animals receiving hypothermia treatment compared to controls. Hypothermia also significantly reduced serum diamine oxidase after CPR compared to the control group. Moreover, severe injury sustained by the gastrointestinal tissue was significantly ameliorated under hypothermic conditions compared to controls.

CONCLUSIONSGastrointestinal injury and abnormal energy metabolism are strikingly evident following CPR. Hypothermia, which is induced by an infusion of 4°C saline, can rapidly reduce internal body temperature, improve energy metabolism, and ameliorate injury to the gastrointestinal mucosa after CPR.

Animals ; Cardiopulmonary Resuscitation ; adverse effects ; Disease Models, Animal ; Energy Metabolism ; Gastrointestinal Tract ; injuries ; Heart Arrest ; therapy ; Hypothermia, Induced ; methods ; Male ; Swine

OBJECTIVETo investigate the effect of electrical stimulation to sacral spinal nerve 3 (S₃ stimulation) on gastrointestinal dysfunction after spinal cord injury (SCI).

METHODSSix rabbits were taken as normal controls to record their gastrointestinal multipoint biological discharge, colon pressure and rectoanal inhibitory reflex. Electrodes were implanted into S₃ in another 18 rabbits. Then the model of SCI was conducted following Fehling's method: the rabbit S₃ was clamped to induce transverse injury, which was claimed by both somatosensory evoked potential and motion evoked potential. Two hours after SCI, S₃ stimulation was conducted. The 18 rabbits were subdivided into 3 groups to respectively record their gastrointestinal electric activities (n=6), colon pressure (n=6), and rectum pressure (n=6). Firstly the wave frequency was fixed at 15 Hz and pulse width at 400 μs and three stimulus intensities (6 V, 8 V, 10 V) were tested. Then the voltage was fixed at 6 V and the pulse width changed from 200 μs, 400 μs to 600 μs. The response was recorded and analyzed. The condition of defecation was also investigated.

RESULTSAfter SCI, the mainly demonstrated change was dyskinesia of the single haustrum and distal colon. The rectoanal inhibitory reflex almost disappeared. S₃ stimulation partly recovered the intestinal movement after denervation, promoting defecation. The proper stimulus parameters were 15 Hz, 400 μs, 6 V, 10 s with 20 s intervals and 10 min with 10 min intervals, total 2 h.

CONCLUSIONS₃ stimulation is able to restore the intestinal movement after denervation (especially single haustrum and distal colon), which promotes defecation.

Animals ; Disease Models, Animal ; Electric Stimulation ; Electrodes, Implanted ; Evoked Potentials, Motor ; physiology ; Evoked Potentials, Somatosensory ; physiology ; Gastrointestinal Tract ; physiopathology ; Rabbits ; Sacrum ; innervation ; Spinal Cord Injuries ; physiopathology

BACKGROUND: Prevotella species is one of the major microoranism responsible for invasive anaerobic bacterial infection. This study was performed to investigate the clinical characteristics and outcome of invasive Prevotella infection in a University affiliated, tertiary care Hospital. METHODS: We obtained the information from the computerized data base of the clinical microbiology laboratory from January 1997 to December 2000, and identified patients whose sterile clinical specimen culture had yielded Prevotella species. We then reviewed the patients' medical records, and studied demographic, clinical, and microbiologic data. RESULTS: The total of 34 patients with invasive Prevotella infection were enrolled for the analysis. Seventeen strains were isolated from blood, 13 from the pleural fluid, 5 from the ascites, and 1 from both the ascites and blood. Half of the cases of Prevotella infection were mixed-infection and 22 cases (64.7%) were of community origin. Twenty-six patients (76%) were men and the mean age was 59 years. Most common underlying disease was malignant neoplasms (19/34, 55.9%). A portal of entry could be determined in 29 patients (85.3%) with the most common being the respiratory tract (12/34, 35.3%), followed by the gastrointestinal tract (6/34, 14.4%), and the wound site (6/34, 14.4%). Surgical procedure was necessary for 21 cases (63.5%). One-month mortality was 32.3%. The mortality was significantly associated with the underlying chronic renal failure (p=0.028) and ICU care (p=0.002). Surgical therapy had a protective effect (54% vs 14%, p=0.022) CONCLUSION: Invasive Prevotella Infections were more prevalent among old age patients with underlying malignancy than younger people and frequently necessitated surgical procedure. Early surgical treatment would decrease mortality.
Aged ; Ascites ; Bacterial Infections ; Gastrointestinal Tract ; Humans ; Kidney Failure, Chronic ; Male ; Medical Records ; Mortality ; Prevotella* ; Respiratory System ; Tertiary Healthcare ; Wounds and Injuries

OBJECTIVETo study the clinical features and prognosis of gastrointestinal injury caused by foreign bodies in the upper gastrointestinal tract in children.

METHODSA retrospective analysis was performed for the clinical data of 217 children who were diagnosed with foreign bodies in the upper gastrointestinal tract complicated by gastrointestinal injury by gastroscopy from January 2011 to December 2016, including clinical features, gastroscopic findings, complications, and prognosis.

RESULTSAmong the 217 children, 114 (52.5%) were aged 1-3 years. The most common foreign body was coin (99/217, 45.6%), followed by hard/sharp-edged food (45/217, 20.7%) and metal (35/217, 16.1%). The most common gastrointestinal mucosal injury was ulceration (43.8%), followed by erosion (33.2%). Compared with other foreign bodies, button cells were significantly more likely to cause esophageal perforation (P<0.01). The esophagus was the most commonly injured organ (207/217, 95.4%). Of all the 217 children, 24 (11.1%) experienced infection. The children with perforation caused by foreign bodies had a significantly higher incidence rate of infection than those with ulceration caused by foreign bodies (P=0.003). Of all the 217 children, 204 (94.0%) underwent successful endoscopic removal of foreign bodies. Among these children, 98 were hospitalized due to severe mucosal injury and were given anti-infective therapy, antacids, and supportive care including enteral nutrition through a nasogastric tube and/or parenteral nutrition. Of all the children, 10 left the hospital and were lost to follow-up, and all the other children were improved and discharged.

CONCLUSIONSMost cases of foreign bodies in the upper gastrointestinal tract occur at 1-3 years of age. Coin, hard/sharp-edged food, and metal are the most common foreign bodies. Button cells are more likely to cause esophageal perforation. The incidence rate of secondary infection increases with the increasing severity of gastrointestinal mucosal injury. Children undergoing endoscopic removal of foreign bodies and enteral nutrition through a nasogastric tube tend to have a good prognosis.

Female ; Food ; adverse effects ; Foreign Bodies ; diagnosis ; etiology ; therapy ; Humans ; Infant ; Male ; Metals ; adverse effects ; Prognosis ; Retrospective Studies ; Upper Gastrointestinal Tract ; injuries

PURPOSE: Actinomycosis is still a relatively rare infection, characterized by multiple abscesses, draining sinuses and the appearance of sulfur granules, which are valuable in aiding the diagnosing the discharge of involved tissues. In most instances, the onset of an abdominal disease is preceded by inflammatory or a traumatic incident resulting in the perforation of the mucosa of the gastrointestinal tract. Intensive and prolonged antimicrobial therapy, and wide surgical excision of involved tissues are the two general principles of therapy. METHODS: We experienced 8 cases of abdominal actinomycosis after a laparotomy between March 1997 and February 2002. RESULTS: The results were as follows: 1) There was a 1: 1 male to female ratio of abdominal actinomycosis, and a mean age of 47 years. 2) The clinical features were different for each involved organ, -but, most of the clinical symptoms were nonspecific to suspect actinomycosis. 3) The frequently involved organs were mainly located lower abdomen, such as the appendix and cecum, sigmoid colon and small bowel. 4) In 60% of the patients, the predisposing factors were identifiable, these being: a previous abdominal operation, IUD and abdominal injury. 5) The preoperative diagnoses included: acute appendicitis, and periappendiceal and intra-abdominal abscesses. The pre-exploratory diagnoses were made by ultrasound and abdominal CT. 6) Explorations were performed in all patients, depending on their diagnosis, to afford the proper surgical treatment and correct diagnosis. After the operation, all the patients were treated with oral antibiotics for long period. CONCLUSION: The authors conclude that pre-exploratory cytological or culture studies, with careful history taking, for low abdominal tumors or abscesses may increase the rate of correct diagnosis, as could proper explorations.
Abdomen ; Abdominal Abscess ; Abdominal Injuries ; Abscess ; Actinomycosis* ; Anti-Bacterial Agents ; Appendicitis ; Appendix ; Causality ; Cecum ; Colon, Sigmoid ; Diagnosis ; Female ; Gastrointestinal Tract ; Humans ; Laparotomy ; Male ; Mucous Membrane ; Sulfur ; Tomography, X-Ray Computed ; Ultrasonography