Cho Min-Kyung, Lee Moon-Soo, Han Hyun-Young, Woo Seung Hyo
Min-Kyung Cho, Moon-Soo Lee, Department of Surgery, Eulji University Hospital, Daejeon 302-799, South Korea.
World J Gastroenterol. 2014 Jun 14;20(22):7075-8. doi: 10.3748/wjg.v20.i22.7075.
Fish bones are the most common foreign objects leading to bowel perforation. Most cases are confined to the extraluminal space without penetration of an adjacent organ. However, abscess formation due to the perforation of the rectosigmoid colon by a fish bone can lead to the penetration of the urinary bladder and may subsequently cause the fish bone to migrate into the urinary bladder. In the presented case, a 42-year-old female was admitted for lower abdominal pain. The computed tomography (CT) demonstrated a 5 cm pelvic abscess containing a thin and curvilinear foreign body. After conservative management, the patient was discharged. After 1 mo, the subject developed a mechanical ileus. Surgery had to be delayed due to her hyperthyroidism. Migration of the foreign body to the urinary bladder was shown on additional CT. A Yellowish fish bone 3.5 cm in size was removed through intra-operative cystoscopy. The patient was discharged 8 d after the operation without any unexpected event.
鱼骨是导致肠穿孔最常见的异物。大多数病例局限于管腔外间隙,未穿透相邻器官。然而,鱼骨导致乙状结肠直肠穿孔引起的脓肿形成可导致膀胱穿孔,并可能随后使鱼骨移入膀胱。在本病例中,一名42岁女性因下腹痛入院。计算机断层扫描(CT)显示盆腔有一个5厘米的脓肿,内含一个细的曲线形异物。经过保守治疗,患者出院。1个月后,该患者出现机械性肠梗阻。由于她患有甲状腺功能亢进症,手术不得不推迟。额外的CT显示异物已移入膀胱。通过术中膀胱镜检查取出了一根3.5厘米长的淡黄色鱼骨。患者术后8天出院,未发生任何意外情况。