Dhandapani Ramyia G, Kumar Susim, O'Donnell Mark E, McNaboe Ted, Cranley Brian, Blake Geoff
Department of General Surgery, Daisy Hill Hospital, Newry BT35 8DR, Northern Ireland, UK.
Cases J. 2009 Feb 3;2(1):117. doi: 10.1186/1757-1626-2-117.
Most foreign bodies pass through the gastrointestinal tract uneventfully. The majority of the reported literature describes the management of ingested blunt objects. However, ingestion of sharp objects can still occur with a higher rate of perforation corresponding to treatment dilemmas.
We report the conservative management of an inadvertently ingested sharp foreign body during a routine dental procedure and describe a management strategy for the treatment of both blunt and sharp foreign bodies.
Urgent endoscopic assessment and retrieval is indicated when there is a history of a recently ingested sharp foreign body or if clinical suspicion suggests that the object is located within the oesophagus. Conservative management is advocated if the object has passed through the pylorus with serial clinical assessments including daily radiographs. Surgical intervention is warranted in the presence of obstruction, perforation or peritonitis.
大多数异物可顺利通过胃肠道。大多数已发表的文献描述了对摄入钝性物体的处理。然而,摄入尖锐物体的情况仍可能发生,且穿孔率较高,这带来了治疗难题。
我们报告了在常规牙科手术期间无意中摄入尖锐异物的保守治疗情况,并描述了钝性和尖锐异物的治疗管理策略。
如果有近期摄入尖锐异物的病史,或临床怀疑异物位于食管内,则需紧急进行内镜评估和取出。如果异物已通过幽门,则主张进行保守治疗,并进行包括每日X光片在内的系列临床评估。出现梗阻、穿孔或腹膜炎时,有必要进行手术干预。