DIFFICULTIES IN DIAGNOSING A FOREIGN BODY IN THE GASTROINTESTINAL TRACT (HYDROGEL) OF A 10-MONTH-OLD CHILD

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Abstract

Abstract. Purpose: informing the doctors who provide aid to children of the peculiarity of the pathology. Methods: a 10-month-old boy who developed recurrent vomiting, cough, nasal discharge and fatigue was admitted to the hospital in his place of residence and diagnosed ARVI with abdominal pain syndrome. In spite of the treatment, the patient’s condition worsened, cerebral edema aggravated, and he received artificial pulmonary ventilation with a diagnosis of acute meningoencephalitis of unclear etiology, cerebral edema, and stage 3 coma. The patient was transferred to the republican hospital where his condition was stabilized using intensive care and correction of water-electrolyte and metabolic disorders. At day 9 after the disease onset, a mobile tumor-like lesion was found on palpation in the right mesogastric region. An abdominal ultrasound showed a round anechogenic lesion with distinct regular outlines (40x40 mm). A surgery was performed to eliminate jejunal obstruction with hydrogel balls. Relaparotomy was done in 6 days. Discussion: this clinical observation shows there are diagnostic difficulties that are unavoidable when a history of peroral intake of hydrogel is lacking. Being in the intestine, hydrogel granules absorbed fluid and their size increased leading to obturation intestinal obstruction. Recurrent vomiting resulted in extrarenal loss of fluid and electrolytes. The patient developed cytotoxic cerebral edema due to hypotonic dehydration. A tumour-like lesion was found on palpation at day 9 after the disease onset. Conclusions: hydrogel balls result in obturation intestinal obstruction with severe water-electrolytic disorders. This pathology requires a surgery with full revision and complete evacuation of foreign bodies from the intestine.

About the authors

R. Kh. Shangareeva

Bashkir State Medical University, Ufa

Author for correspondence.
Email: shanrosa@mail.ru
ORCID iD: 0000-0001-8917-1399

Dr. Sci (Med), Professor of the Department of Pediatric Surgery with course of IAPE, Bashkir State Medical University

Russian Federation

A. A. Mirasov

Republican Children’s Clinical Hospital, Ufa

Email: mirasov1@yandex.ru
Cand. Sci (Med), Head of the Anesthesiology and Resuscitation Department, Republican Children’s Clinical Hospital Russian Federation

R. R. Zaynullin

Republican Children’s Clinical Hospital, Ufa

Email: zainullin369@mail.ru
Head of the Surgery Department, Republican Children’s Clinical Hospital Russian Federation

P. Yu. Soldatov

Bashkir State Medical University, Ufa;
Municipal children’s clinical hospital № 17, Ufa

Email: fake@neicon.ru
ORCID iD: 0000-0002-9656-1093
Assistant of the Department of Pediatric Surgery with course of IAPE, Bashkir State Medical University Russian Federation

G. R. Valeeva

Bashkir State Medical University, Ufa;
Municipal children’s clinical hospital № 17, Ufa

Email: gulnaz_valeeva90@mail.ru
ORCID iD: 0000-0003-0728-1469
Assistant of the Department of Pediatric Surgery with course of IAPE, Bashkir State Medical University Russian Federation

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Copyright (c) 2019 Shangareeva R.K., Mirasov A.A., Zaynullin R.R., Soldatov P.Y., Valeeva G.R.

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