Benda Asing Kait Gorden di Esofagus pada Anak Usia 8 Bulan dengan COVID-19

Widia Isa Aprillia Sujana

Abstract


Abstrak

Latar Belakang: Kasus tertelan benda asing masih merupakan  masalah yang sering terjadi pada anak. Benda asing tajam di esofagus memiliki tingkat morbiditas dan mortalitas yang tinggi sehingga memerlukan diagnosis yang tepat dan tatalaksana yang segera. Infeksi COVID-19 pada anak seringkali asimptomatik, pada kasus anak dengan pemeriksaan serologi ECLIA positif, prosedur esofagoskopi segera perlu dilakukan dengan protokol COVID-19. Tujuan: Memahami lebih mendalam penegakan diagnosis dan penatalaksanaan ekstraksi benda asing tajam (kait gorden) di esofagus pada anak dengan protokol COVID-19. Laporan kasus: Anak laki-laki usia 8 bulan menelan 1 buah kait gorden. Presentasi klinis dan hasil pemeriksaan radiografi menunjukkan adanya benda asing berdensitas logam di esofagus dan hasil pemeriksaan ECLIA positif. Pasien direncanakan esofagoskopi ekstraksi dan eksplorasi dengan pembiusan umum dan protokol COVID-19. Metode: Telaah literatur berbasis bukti melalui pencarian PubMed dan Google Scholar serta buku ajar yang yang memiliki relevansi dengan topik serta naskah lengkap tersedia. Hasil: Pengambilan benda asing tajam esofagus pada anak direkomendasikan dengan menggunakan endoskopi kaku dengan pembiusan umum dan dikerjakan dalam waktu <24 jam. Teknik yang digunakan berhubungan dengan arah ujung tajam dari benda asing. Skrining preoperasi, penggunaan APD, dan ruangan operasi bertekanan negatif serta pembuatan surgical tent mengurangi resiko transmisi. Kesimpulan: Penegakan diagnosis yang tepat, intervensi endoskopi segera dengan teknik dan pemilihan alat ekstraksi yang tepat, dan dengan pembiusan umum direkomendasikan pada penanganan kasus tertelan benda asing tajam pada anak. Skrining preoperasi dan penerapan protokol COVID-19 wajib dilakukan pada pasien anak dengan kecurigaan COVID-19.

Kata Kunci: tertelan benda asing, benda asing tajam esofagus, anak, esofagoskopi, COVID-19

 

Abstract

Background: Foreign body ingestion case still a common problem among children. Sharp foreign body have high morbidity and mortality rate that need correct diagnosis and management. COVID-19 infection in children usually asymptomatic, in the case of children with ECLIA positive, esophagoscopy procedure need to be done with COVID-19 protocol. Purpose: To understand diagnosis and management of sharp foreign body (curtain hook) extraction in children with COVID-19 protocol. Case report: A boy 8 month old have been reported ingested a curtain hook. Clinical presentation and radiography examination showing foreign body in esophagus and ECLIA positive. The patient planned to undergoing esophagoscopy extraction and exploration with general anesthesia and COVID-19 protocol. Methods: Evidence-based literature review via PubMed, Google Scholar and also textbook that relevant with topic and script available. Result: Rigid endoscope extraction with general anesthesia within 24 hours is recommended for esophagus foreign body in children. The sharp egde of the foreign body determine the technique being used. Preoperative screening, PPE use, and negative pressure operating room also creation of surgical tent reduce the risk of transmission. Conclusion: Right diagnosis, immediate endoscopic intervension with right technique and extraction tool under general anesthesia are recommended for sharp foreign body ingestion in children. COVID-19 protocol is a must to child patient with sucspicion of COVID-19.

Keywords: foreign body ingestion, sharp foreign body in esophagus, children, esophagoscopy, COVID-19

Keywords


foreign body ingestion, sharp foreign body in esophagus, children, esophagoscopy, COVID-19

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