Abate Getahun, Shirin Mazumder, Kandanati Vivek
Division of Infectious Diseases, Department of Internal Medicine, Saint Louis University, St. Louis, MO 63104, USA.
J Emerg Med. 2013 Feb;44(2):e247-9. doi: 10.1016/j.jemermed.2012.09.018. Epub 2012 Nov 29.
Medical and surgical problems associated with rectal foreign bodies are rare. Although most rectal foreign bodies can be removed without subsequent sequelae, they pose significant risk of infection.
We report a patient with a 32-cm rectosigmoid foreign body and subsequent development of Fournier gangrene despite successful removal of the foreign body.
A 63-year-old Caucasian man with past medical history of diabetes mellitus and depression presented with a chief complaint of "something stuck in my intestine." He admitted that he placed a foreign body in the rectum. Abdominal X-ray study and computed tomography of the abdomen/pelvis showed a conical-shaped 32-cm rectosigmoid foreign body. The foreign body was removed manually and follow-up colonoscopy was done. The patient's condition deteriorated in the first 2 days of hospital stay and he was diagnosed with Fournier gangrene. He required multiple surgeries and received broad-spectrum antibiotic coverage for mixed bacterial flora grown from deep tissue.
Rectal foreign bodies can cause Fournier gangrene. A close observation and follow-up is important after removal of rectal foreign bodies.
与直肠异物相关的医学和外科问题较为罕见。尽管大多数直肠异物可以在不产生后续后遗症的情况下取出,但它们会带来显著的感染风险。
我们报告一例直肠乙状结肠有32厘米异物的患者,尽管异物成功取出,但随后发生了福尼尔坏疽。
一名63岁的白人男性,有糖尿病和抑郁症病史,主诉为“有东西卡在我的肠道里”。他承认自己在直肠内放入了一个异物。腹部X线检查和腹部/盆腔计算机断层扫描显示一个32厘米长的圆锥形直肠乙状结肠异物。异物被手动取出,并进行了后续结肠镜检查。患者在住院的头两天病情恶化,被诊断为福尼尔坏疽。他需要多次手术,并接受了针对从深部组织培养出的混合细菌菌群的广谱抗生素治疗。
直肠异物可导致福尼尔坏疽。直肠异物取出后密切观察和随访很重要。