小児食道異物症例—最近の症例ならびに統計的観察

Esophageal Foreign Body in a Child, and Statistical Survey

　I．はじめに

　食道異物症は小児に比較的多くみられる疾患である^1〜5）。多くの場合，異物誤嚥の病歴が明らかであるが，時にはそれが明らかでなく，病状不明のまま確定診断までの間，迂余曲折の経過をとることがある。放置されて時に重篤な合併症あるいは後遺症をおこしかねない疾患である^6〜9）。

　私共は最近，異物誤嚥の病歴が明らかでなく，感冒として長期間治療され，食道造影検査で初めて異物の存在が疑われた症例を経験した。症例報告とともに，昭和51年から55年までの5年間に当科で食道異物症またはその疑いの診断のもとに食道直達鏡検査を施行した75例のうち，食道内に異物の存在を確認した55例について集計し，あわせて若干の文献的考察を加えて報告した。

　A 4-year-old boy, who had mental retardation (so-called floppy infant), was noted to have dysphagia and excessive salivation .He was treated by a pediatrician conservatively as having common cold for a long time before he was referred to our clinic. Even though his mother strongly denied that he had misswallowed any foreign body, roentgenological and endoscopical examinations revealed a foreign body of swollen bush bean in the esophagus. Statistical survey of fifty-five cases with foreign bodies in the esophagus collected at our clinic from 1976 to 1980 was performed. The results were as follows: 1) Of the 55 cases, 30 were males and 25 were females. 2) Twenty four cases (44%) occurred in children under 10 years of age. 3) Twenty-seven per cents of the foreign bodies were coins, and another 27 per cents were bones. 4) Food foreign bodies were observed dominantly in patients over 60 years of age, and non-food foreign bodies in patients under 10 years of age.