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不当使用(电子)按摩器导致直肠异物嵌顿:一例病例报告

Impaction of a foreign body in the rectum by improper use of a (electronic) massager: a case report.

作者信息

Jung Eun-Joo, Ryu Chun-Geun, Kim Gangmi, Hwang Dae-Yong

机构信息

Colorectal Cancer Center, Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

出版信息

J Korean Soc Coloproctol. 2010 Aug;26(4):298-301. doi: 10.3393/jksc.2010.26.4.298. Epub 2010 Aug 31.

Abstract

A male, 67 years old, visited the emergency room because of a foreign body impacted in his rectum. While he was being treated for grade-II hemorrhoids conservatively, he heard that massage of the peri-anal area could be helpful for preventing hemorrhoids. Thus, while using an electronic massager after placing the head of the machine into a short round bar, the head became separated from the machine, and this was inserted into the anus and impacted. The patient had anal discomfort without abdominal pain. His vital signs were stable, and no abnormal physical findings were found for the abdomen. On digital rectal examination, the rim of the foreign body was palpated about 8 cm from the anal verge. Anal bleeding, abnormal discharge, or foul odor was not found. On a simple abdominal X-ray, a radio-opaque foreign body was observed in the pelvic cavity, and mild leukocytosis was noted on the laboratory test. To avoid injury to the anal sphincter, we tried to remove the foreign body under the spinal anesthesia. After anesthesia had been administered, the foreign body was palpated more distally at 5-6 cm from the anal verge by digital examination, and the foreign body was found to have a hole in its center. This was held using a Kelly clamp, and with digital guiding, was removed through the anus. After removal, an anoscopic examination was performed to determine if mucosal injury had occurred in the rectum or anal canal. The patient was discharged without complication after 24 hours of close observation.

摘要

一名67岁男性因直肠内有异物嵌顿而前往急诊室。他正在接受Ⅱ度痔疮的保守治疗时,听说按摩肛周区域有助于预防痔疮。因此,他将电子按摩器的头部插入一根短圆棒后使用时,头部与机器分离,该头部被插入肛门并嵌顿。患者有肛门不适,但无腹痛。他的生命体征稳定,腹部未发现异常体征。直肠指检时,在距肛缘约8厘米处可触及异物边缘。未发现肛门出血、异常分泌物或恶臭。腹部X线平片显示盆腔内有不透X线的异物,实验室检查发现轻度白细胞增多。为避免损伤肛门括约肌,我们尝试在脊髓麻醉下取出异物。麻醉后,通过直肠指检发现异物在距肛缘5 - 6厘米处更靠远端,且异物中心有一个洞。用凯利钳夹住异物,并在手指引导下经肛门取出。取出后,进行肛门镜检查以确定直肠或肛管是否发生黏膜损伤。经过24小时的密切观察,患者无并发症出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25e1/2998008/3bce4cb76aff/jksc-26-298-g001.jpg

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