Surgical Management In Accidental Ingestion of Jujube Pits in Children

Abstract

Purpose: Accidental ingestion of jujube pits is rare in children due to worldwide differences in food habits and agricultural cultivation. With its special shape, jujube pits can insert intestinal wall which are easier to cause injury and perforation than other foreign bodies(FBs). This study aims to summarize our experience with surgical treatment of jujube pits ingestion in children. Methods: We performed a retrospective analysis of the patients who were diagnosed as jujube pits ingestion and experienced surgery at pediatric general surgery department of Shanghai Children’s hospital between January 2014 to February 2022.Demographics and information regarding the characteristics of jujube pits, clinical presentation, treatment strategies were documented. Results: A total of 11 pediatric patients with jujube pits were included in this study contains 7 males and 4 females. The mean age was 23.6 months. The frequent clinical presentations are vomiting and abnormal defecation. Computed tomography(CT) imaging revealed jujube pits in 10 patients. Four patients experienced abdominal surgery and a secondary ileostomy was performed in one patient. Eleven patients experienced anal or buttock surgery and colonoscopy. Two patients were admitted in surgery intensive care unit after surgery and the median hospital stay of all was 11.5 days(range 6-32 days).Patients discharged with normal fasting and defecation. Conclusion: Jujube pits ingestion is rare and the clinical presentations can be variable depend on the injured position. CT imaging is recommended to locate the foreign bodies and identify positive findings. The diagnosis is confirmed when clear history of jujube pits ingestion was provided. When patients present with abnormal defecation, the possibility of foreign bodies ingestion should be considered. In symptomatic patients, surgery intervention should be applied timely.