Santander-Flores Selene Artemisa, Mata-Quintero Carlos Javier, O'Farrill-Anzures Ricardo, González-Villegas Paloma, Calvo-Vázquez Iván, Campos-Serna Esteban Israel
Servicio de Cirugía General, Hospital Central Norte de Petróleos Mexicanos, Ciudad de México, México.
Servicio de Cirugía General, Hospital Central Norte de Petróleos Mexicanos, Ciudad de México, México.
Cir Cir. 2017 Jul-Aug;85(4):350-355. doi: 10.1016/j.circir.2016.04.003. Epub 2016 Jun 16.
Foreign body ingestion is the second cause of endoscopic emergency in the elderly, and dentures are the most frequent accidently ingested objects. Once in the stomach, their expulsion can be expected in 4 to 6 days. The treatment is wait and see in asymptomatic patients, but preventive endoscopic removal can also be performed.
To present 2 scenarios of the outcome and treatment in patients with foreign body ingestion.
Patient under study due to weight loss, with a denture detected by abdominal x-ray, ingested inadvertently a year ago. A laparotomy was required as extraction by colonoscopy failed, due to excessive inflammation. The second case, of 24-hour onset, was due to the ingestion of a partial denture. As duodenal endoscopy extraction was unsuccessful, the patient was kept under observation. When it did not pass the caecum, it was extracted by colonoscopy, with no further complications and shorter hospital stay.
Follow-up can be by simple abdominal x-ray, with endoscopic management if there is insufficient progress. In one of our cases, the outcome was unfavourable due to time of ingestion, and endoscopic management was not possible, whereas in the second case colonoscopy was performed early with success. Proper diagnostic and timely treatment mark the difference in the progression and outcome of the ingestion of foreign bodies.
异物摄入是老年人内镜急诊的第二大原因，假牙是最常意外摄入的物体。一旦进入胃内，预计4至6天可排出。对于无症状患者，治疗方法是观察等待，但也可进行预防性内镜取出。
介绍异物摄入患者的两种结局及治疗情况。
研究中的患者因体重减轻，腹部X线检查发现一年前意外摄入一副假牙。由于炎症过重，结肠镜检查未能取出，因此需要进行剖腹手术。第二例患者在摄入假牙24小时后就诊，因十二指肠内镜取出失败，对其进行观察。当假牙未通过盲肠时，通过结肠镜检查将其取出，未出现进一步并发症，住院时间较短。
可通过简单的腹部X线进行随访，如果进展不充分则进行内镜处理。在我们的一个病例中，由于摄入时间较长，结局不佳，无法进行内镜处理；而在第二个病例中，早期进行结肠镜检查取得成功。正确的诊断和及时的治疗是异物摄入进展和结局存在差异的关键。
