Chiu Wen-Kuan, Hsiao Cheng-Wen, Kang Jung-Cheng, Feng Jan-Jen, Chao Pei-Chieh, Jao Shu-Wen
Division of Colon and Rectum Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Clin Pediatr (Phila). 2007 Sep;46(7):636-8. doi: 10.1177/0009922807300701. Epub 2007 Jun 6.
Rectal perforation is a serious complication of manipulation of the anus and rectum, with catheters and thermometers. Such procedures should be performed with caution. We report a case of a 19-year-old male with retention of an intrapelvic foreign body, a mercury thermometer, which after perforating the rectum migrated into the pelvis and remained there without any symptoms for the next 7 years. A mercury thermometer, broken into 2 fragments, retained in the pelvis was noted accidentally by pelvic roentgenogram examination. An extrinsic thermometer tip over the upper rectal region was palpable by digital rectal examination. On physical examination, no infections or signs of peritonitis were observed. There were no significant abnormal findings by flexible colonoscopy. Computed tomography revealed a foreign body retained in the pelvis. Blood mercury level and a 24-hour urinary measurement of mercury were within normal limits. The patient refused any further treatment since he did not have any discomfort. The patient was in good condition and had not had surgery in the preceding 7 years.
直肠穿孔是肛门和直肠操作(如使用导管和温度计)的严重并发症。此类操作应谨慎进行。我们报告一例19岁男性病例,其盆腔内有一异物滞留,为一支汞温度计,该温度计在直肠穿孔后移入盆腔,并在接下来的7年里一直留在那里且无任何症状。盆腔X线检查偶然发现盆腔内有一支断裂为两段的汞温度计。直肠指检可触及直肠上段上方有一外置的温度计尖端。体格检查未发现感染或腹膜炎体征。结肠镜检查未发现明显异常。计算机断层扫描显示盆腔内有一异物滞留。血汞水平及24小时尿汞测量均在正常范围内。由于患者无任何不适,拒绝进一步治疗。患者状况良好,在过去7年中未接受过手术。