Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan.
Int J Infect Dis. 2010 Feb;14(2):e171-2. doi: 10.1016/j.ijid.2009.03.024. Epub 2009 Jun 21.
Foreign body ingestion is not an uncommon problem encountered in clinical practice. The accidental ingestion of fish bones may sometimes lead to penetration injuries with complicating abscess formation. The ingestion of foreign bodies results in gastrointestinal perforation in about 1% of patients. Fish bones are the most commonly seen objects leading to bowel perforation. Fish bones are usually invisible on plain films. A computed tomography (CT) scan of the abdomen is helpful to determine the cause of unexplained and persistent abdominal pain. If encapsulated abscess formation cannot be completely resolved by CT-guided drainage, surgical intervention should proceed to prevent profound sepsis. We present the case of a 75-year-old man who had fever and left lower abdominal pain. CT showed a hypodense lesion with a linear foreign body in the abdomen. An intra-abdominal abscess was diagnosed and after surgical intervention, a foreign body, which proved to be a fish bone, was removed. The man could not remember swallowing this bone.
异物摄入在临床实践中并不少见。鱼刺的意外摄入有时可导致穿透性损伤,并伴有脓肿形成。异物摄入导致胃肠道穿孔的发生率约为 1%。鱼刺是导致肠穿孔最常见的异物。鱼刺在平片上通常不可见。腹部 CT 扫描有助于确定不明原因和持续性腹痛的病因。如果 CT 引导下引流不能完全解决包裹性脓肿形成,应进行手术干预,以防止严重脓毒症。我们报告了一例 75 岁男性,发热和左下腹痛。CT 显示腹部有一个低密病灶,伴线性异物。诊断为腹内脓肿,经手术干预后取出异物,证实为鱼刺。该患者记不得曾吞下该鱼骨。