Dente M, Cilurso F, Fornari L, Morano C, Moretti M, Neri T, Solinas L, Tiberi R, Anastasio G, Santi F, Bagarani M
Dipartimento di Chirurgia Digestiva ed Endocrina, Ospedale Regina Apostolorum, Albano, Roma.
G Chir. 2010 Jan-Feb;31(1-2):38-41.
Usually the ingested foreign bodies (IFB) pass the gastrointestinal tract making no lesions. Sometimes IFB could lead to a gastrointestinal perforation. The most frequently perforating IFB are chicken or fish bones and toothpicks, while risks factors are mental retardation, alcohol or drug abuse, denture usage, quick eating or habitual chewing of toothpicks. The accidentally ingestion in a high risk patient with unclear symptoms, added to a low sensitive diagnostic imaging, lead to intraoperative diagnosis in one half cases of gastrointestinal perforation by IFB. Furthermore the surgical treatment range between the less minimal invasive laparoscopic IFB extraction and intraabdominal hole suture to a laparotomic bowel or colic resection. Herein we describe our experience in 3 cases of gastrointestinal perforation by IFB have been diagnosed at surgery and treated by IFB extraction and hole suture (in 2 patients; 1 laparoscopy, 1 laparotomy) or open right emicolectomy (1 patient).
通常,摄入的异物(IFB)会通过胃肠道而不造成损伤。有时,IFB可能导致胃肠道穿孔。最常导致穿孔的IFB是鸡骨或鱼骨以及牙签,而危险因素包括智力迟钝、酗酒或药物滥用、使用假牙、进食过快或习惯性咀嚼牙签。在症状不明确的高危患者中意外摄入异物,加上诊断性影像学检查敏感性较低,导致一半的IFB所致胃肠道穿孔病例在术中才得以诊断。此外,手术治疗范围从创伤较小的腹腔镜IFB取出术和腹腔内孔洞缝合到开腹肠段或结肠切除术不等。在此,我们描述了3例IFB所致胃肠道穿孔的经验,这些病例均在手术中确诊,并通过IFB取出和孔洞缝合(2例患者;1例腹腔镜手术,1例开腹手术)或开放性右半结肠切除术(1例患者)进行治疗。