Bhatia R, Deane A J B, Landham P, Schulte K-M
Department of General Surgery (Breast/Endocrine), King's College Hospital, Denmark Hill, London, UK.
Int J Clin Pract. 2006 Feb;60(2):229-31. doi: 10.1111/j.1742-1241.2006.00610.x.
We reported the case of an 85-year-old woman who presented with an acutely tender abdomen and underwent abdominal computed tomography (CT) scanning initially reported as showing diverticulitis. After failed conservative management, this patient was taken to theatre, and laparotomy revealed a punctate perforation of the ileum due to a 4 x 3 cm fish fin, which was removed through enterotomy. Retrospective analysis of the initial CT scans showed a foreign body consistent with that removed. This is the first case documented in the literature of perforation of bowel due to fish fin ingestion, as opposed to fish bone. It highlights firstly how common presentations may have an uncommon cause and secondly, how easily a small foreign body can be missed on CT scan. It also highlights and the importance of (i) eliciting a full history of eating habits in those presenting with abdominal pain and (ii) basing intervention on clinical findings. In this case report, we review the wider medical literature on perforation due to foreign body ingestion.
我们报告了一例85岁女性患者，她因腹部急性压痛就诊，最初接受腹部计算机断层扫描（CT），报告显示为憩室炎。保守治疗失败后，该患者接受手术，剖腹探查发现一段4×3厘米的鱼鳍导致回肠出现点状穿孔，通过肠切开术将鱼鳍取出。对最初CT扫描的回顾性分析显示有一个与取出物相符的异物。这是文献记载的首例因吞食鱼鳍而非鱼骨导致肠道穿孔的病例。它首先凸显了常见症状可能有不寻常病因的情况，其次，也表明了CT扫描很容易漏诊小的异物。它还强调了（i）对腹痛患者详细询问饮食习惯的重要性以及（ii）根据临床发现进行干预的重要性。在本病例报告中，我们回顾了关于异物吞食导致穿孔的更广泛医学文献。
