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腹腔镜取出前肠“顽固”异物:一例报告及文献综述

Laparoscopic retrieval of "stubborn" foreign bodies in the foregut: a case report and literature survey.

作者信息

Palanivelu Chinnusamy, Rangarajan Muthukumaran, Rajapandian Subbiah, Vittal Sai Krishna, Maheshkumaar Gobi Shanmugham

机构信息

GEM Hospital, 45-A, Pankaja Mill Road, Ramanathapuram, Coimbatore, India.

出版信息

Surg Laparosc Endosc Percutan Tech. 2007 Dec;17(6):528-31; discussion 31-2. doi: 10.1097/SLE.0b013e31815ac599.

Abstract

INTRODUCTION

Foreign bodies (FBs) are commonly seen in pediatric and gastroenterologist practice. Most of them will pass without intervention; those that do not will need surgery. Laparoscopy has been used to achieve this to good effect. We present a child with ingestion of multiple magnets.

CASE REPORT

The patient was a 2-year-old child with history of ingestion of magnets. Laparoscopy was planned as endoscopic removal had failed. There were 3 magnets in the stomach and 1 in the jejunum and they were attached together, as if in a "gastrojejunostomy." Laparoscopic removal was performed successfully for the child.

RESULTS

He had an uneventful postoperative recovery and was discharged on the third postoperative day.

DISCUSSION

Coins are the most commonly ingested FBs. Multiple magnet ingestion poses a unique problem, as they are likely to stick together and cause pressure necrosis with fistula formation. Surgical intervention is necessary to prevent this potentially deadly complication.

CONCLUSIONS

Laparoscopy has been found to be very useful in the removal of intraluminal FBs, especially when conservative measures fail. Prevention should be the main objective and parental involvement is crucial.

摘要

引言

异物在儿科和胃肠病科临床中较为常见。大多数异物无需干预即可自行排出;无法自行排出的则需要手术治疗。腹腔镜检查已被用于此,且效果良好。我们报告一例吞食多枚磁铁的儿童病例。

病例报告

该患者为一名2岁儿童,有吞食磁铁的病史。因内镜取出失败,计划进行腹腔镜检查。胃内有3枚磁铁,空肠内有1枚,它们相互粘连,宛如“胃空肠吻合术”。成功为该儿童实施了腹腔镜取出术。

结果

术后恢复顺利,术后第三天出院。

讨论

硬币是最常见的吞食异物。吞食多枚磁铁会带来独特问题,因为它们可能相互粘连,导致压迫性坏死并形成瘘管。必须进行手术干预以预防这种潜在的致命并发症。

结论

已发现腹腔镜检查在取出腔内异物方面非常有用,尤其是在保守措施失败时。预防应是主要目标,家长的参与至关重要。

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