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腹痛的罕见病因:阑尾内有三颗铅弹。

An Unusual Cause of Abdominal Pain: Three Lead Pellets within the Appendix Vermiformis.

作者信息

Ozkan Orhan Veli, Muderris Vecdi, Altintoprak Fatih, Yagmurkaya Orhan, Yalkin Omer, Celebi Fehmi

机构信息

Department of General Surgery, Faculty of Medicine, Sakarya University, Sakarya, Turkey.

Department of General Surgery, Research and Educational Hospital, Sakarya University, Sakarya, Turkey.

出版信息

Case Rep Surg. 2015;2015:496372. doi: 10.1155/2015/496372. Epub 2015 May 28.

Abstract

Most ingested foreign bodies usually pass out in the feces uneventfully. Complications such as intestinal perforation and bleeding usually occur with sharp, thin, stiff, long, and pointed objects. This case describes the management of three lead pellets within the appendix vermiformis. A 45-year-old male visited our clinic complaining of a 4-month history of abdominal pain. The patient inquiry revealed that he had eaten hunted rabbit meat on numerous occasions and had unintentionally ingested three lead pellets. Plain abdominal films and a barium enema showed foreign bodies in the right lower abdominal quadrant. Since the lead pellets were thought to have migrated extraluminally, they were removed through laparotomy under fluoroscopic guidance. An appendectomy was performed. Pathologically, three lead pellets were embedded in the appendix, which showed signs of intramucosal inflammation. Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects enter the appendicular lumen, there is a high risk of appendicitis, perforation, or abdominal pain. An appendectomy was required to remove the ingested lead pellets in the appendix.

摘要

大多数摄入的异物通常会顺利随粪便排出。诸如肠穿孔和出血等并发症通常发生于尖锐、细长、坚硬、带尖的物体。本病例描述了对位于阑尾内的三颗铅弹的处理。一名45岁男性因腹痛4个月前来我院就诊。询问患者得知,他曾多次食用猎获的兔肉,无意中摄入了三颗铅弹。腹部平片和钡灌肠显示右下腹象限有异物。由于认为铅弹已迁移至管腔外,遂在荧光镜引导下通过剖腹手术将其取出。同时进行了阑尾切除术。病理检查显示,三颗铅弹嵌入阑尾,阑尾呈现黏膜内炎症迹象。导致阑尾炎的异物很少见。然而,如果坚硬或带尖的物体进入阑尾腔,发生阑尾炎、穿孔或腹痛的风险很高。需要进行阑尾切除术以取出阑尾内摄入的铅弹。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8714/4464593/5662ade2e139/CRIS2015-496372.001.jpg

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