Rosón Rodríguez Pedro J, López Ortega Susana, Melgarejo Cordero Francisco, Vázquez Pedreño Luis, Fernández Castañer Alejandra
Servicio de Gastroenterología y Unidad de Endoscopia Digestiva Intervencionista, Hospital Xanit Internacional, Benalmádena, Málaga, España.
Gastroenterol Hepatol. 2009 Oct;32(8):552-6. doi: 10.1016/j.gastrohep.2009.04.010. Epub 2009 Jul 31.
Intake of foreign bodies is the second most frequent indication for urgent upper gastrointestinal endoscopy. Once in the stomach, foreign bodies are usually spontaneously eliminated. However, a small percentage of large or sharp objects become stuck in the gastrointestinal mucosa. Fish bones represent a substantial number of ingested foreign bodies. We present two cases of fish bone intake producing gastric perforation satisfactorily resolved with endoscopy. Perforation is considered an absolute spcontraindication for upper and lower gastrointestinal endoscopy. Cases such as those reported herein indicate that the decision to perform endoscopic treatment should always be individualized since punctiform perforations - especially if associated with a parietal and peritoneal inflammatory reaction that helps to close the perforation spontaneously - can be treated non-surgically.
摄入异物是紧急上消化道内镜检查的第二常见指征。异物一旦进入胃内，通常会自行排出。然而，一小部分大的或尖锐的物体可能会卡在胃肠道黏膜中。鱼骨是大量摄入的异物之一。我们报告两例鱼骨摄入导致胃穿孔的病例，通过内镜检查得到了满意的解决。穿孔被认为是上、下消化道内镜检查的绝对禁忌证。本文报道的此类病例表明，内镜治疗的决定应始终个体化，因为点状穿孔——特别是如果伴有有助于自发闭合穿孔的壁层和腹膜炎症反应——可以采用非手术治疗。
