Avcu Serhat, Unal Ozkan, Ozen Ozkan, Bora Aydın, Dülger Ahmet Cumhur
Department of Radiology, Yüzüncü Yil University School of Medicine, Van, Turkey.
N Am J Med Sci. 2009 Sep;1(4):193-5.
Swallowing foreign bodies is a common problem in children. Although most objects pass through the gastrointestinal tract with no untoward effect; long, sharppointed, or slender objects can perforate the gut. Migration of a swallowed object to the liver is extremely rare and very few cases have been reported in the literature up to now. The aim of this study is to draw attention to this subject once again by contributing a case report of a child with hepatic migration of a swallowed sewing needle.
A 16-year-old girl presented to the emergency room of pediatrics department in our hospital with complaints of abdominal pain, nausea and vomiting. Physical examination revealed tenderness on the right upper quadrant of the abdomen. Laboratory examination revealed increased hepatic enzymes as well as increased white blood cell count. Abdominal ultrasonography and computed tomography examinations revealed foreign body in the liver accompanied by surrounding abscess formation. The foreign body (sewing needle) was removed surgically after two operations.
The children may not be able to remember the swallowing of the foreign body or they may try to hide such a condition. The radiological diagnosis in such cases which can be achieved by X-rays, ultrasonography or computed tomography is of critical importance, as well as getting detailed patient history for foreign body swallowing.
吞食异物是儿童常见的问题。尽管大多数异物可通过胃肠道而无不良影响,但长的、尖锐的或细长的物体可能会穿透肠道。吞食的物体迁移至肝脏极为罕见,迄今为止文献中报道的病例很少。本研究的目的是通过提供一例吞食缝衣针后肝脏迁移的儿童病例报告,再次引起对该问题的关注。
一名16岁女孩因腹痛、恶心和呕吐到我院儿科急诊室就诊。体格检查发现腹部右上象限压痛。实验室检查显示肝酶升高以及白细胞计数增加。腹部超声和计算机断层扫描检查显示肝脏内有异物并伴有周围脓肿形成。经过两次手术后,通过手术取出了异物(缝衣针)。
儿童可能记不起吞食异物的情况,或者他们可能试图隐瞒这种情况。在这类病例中,通过X射线、超声或计算机断层扫描进行放射学诊断至关重要,同时获取详细的吞食异物患者病史也很重要。