Early colonic-preparation and salvage laparoscopic appendectomy (ECSLA)- innovative protocol for the management of magnets ingestion.

IF 2 Q2 EMERGENCY MEDICINE

International Journal of Emergency Medicine Pub Date : 2024-07-15 DOI:10.1186/s12245-024-00678-2

Ortal Schaffer, Adi Kenoshi, Osnat Zmora

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引用次数: 0

Abstract

Background: Ingestion of magnets carries risks for significant morbidity. We propose a new protocol designed to reduce the need for surgery, shorten length of stay, and decrease morbidity.

Methods: The Early Colonic-preparation and Salvage Laparoscopic Appendectomy (ECSLA) protocol includes initiating colonoscopy preparation upon admission in asymptomatic patients if magnets are not amenable to removal by gastroscopy, and laparoscopic magnets retrieval via appendectomy if surgery is eventually needed. The protocol was initiated in May 2023. A retrospective study of all cases of ingested magnets in children in our institution during July 2020 - January 2024 was conducted to retrieve and analyze demographic, clinical, imaging, management, and outcome data.

Results: During the 3.5-year study period, 13 cases of ingested multiple magnets were treated, including 7 cases since initiation of ECLSA protocol, with no complications. Since initiation of ECSLA protocol, Early colonic preparation resulted in spontaneous passage of magnets (two cases) and successful colonocsopic removal (three cases), with two cases in which magnets were retrieved via gastroscopy upon admission, and no patients needing surgical intervention. Length of stay (LOS) was short (1-3 days).

Conclusions: The ECSLA protocol is a promising tool for preventing surgical intervention and complications and for possibly shortening LOS in children who have ingested multiple magnets.

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早期结肠准备和腹腔镜阑尾切除术（ECSLA）--处理磁铁摄入的创新方案。

背景：误食磁铁有可能导致严重的发病率。我们提出了一项新方案，旨在减少手术需求、缩短住院时间并降低发病率：早期结肠准备和抢救性腹腔镜阑尾切除术（ECSLA）方案包括：如果磁铁无法通过胃镜取出，无症状患者在入院时开始结肠镜准备；如果最终需要手术，则通过阑尾切除术进行腹腔镜磁铁取出。该方案于 2023 年 5 月启动。我们对 2020 年 7 月至 2024 年 1 月期间我院所有误食磁铁的儿童病例进行了回顾性研究，以检索和分析人口统计学、临床、影像学、管理和结果数据：在 3.5 年的研究期间，共治疗了 13 例误食多块磁铁的病例，其中 7 例是自 ECLSA 方案启动以来治疗的，均未出现并发症。自启动 ECSLA 方案以来，早期结肠准备使磁铁自发通过（2 例），结肠镜下成功取出（3 例），其中 2 例在入院时通过胃镜取出磁铁，没有患者需要手术干预。住院时间（LOS）较短（1-3 天）：ECSLA方案是一种很有前途的工具，可预防手术干预和并发症，并有可能缩短误食多块磁铁的儿童的住院时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Emergency Medicine EMERGENCY MEDICINE-

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.