Gebresellassie Hailu Wondimu
Department of Surgery, School of Medicine, College of Health Sciences, AAU, Addis Ababa, Ethiopia.
J Med Case Rep. 2016 Sep 17;10(1):257. doi: 10.1186/s13256-016-1044-y.
The act of deliberate injury to one's own body without the help of others is a well-known phenomenon in psychiatric patients. Insertion of foreign bodies into one or more orifices is not uncommon but insertion into a body cavity or the gastrointestinal tract by self-inflicted injury is quite rare.
A 32-year-old Ethiopian psychiatric patient presented with left lower abdominal pain of three months' duration following the insertion of foreign bodies via a self-inflicted wound in the left lower quadrant of his abdomen. Radiological evaluation demonstrated the presence of foreign bodies. A laparotomy revealed two metallic and three wooden materials in his sigmoid colon and a hole in his sigmoid that was tightly sealed with omentum. The foreign bodies were successfully removed, the hole was closed primarily, and our patient was discharged uneventfully.
This case illustrates that a foreign body can be inserted into the colon through a self-inflicted wound in psychiatric patients, and patients may present months later without having developed generalized peritonitis.
在没有他人帮助的情况下故意伤害自己身体的行为在精神科患者中是一种众所周知的现象。将异物插入一个或多个孔窍并不罕见,但通过自我伤害将异物插入体腔或胃肠道则相当罕见。
一名32岁的埃塞俄比亚精神科患者,在通过自我造成的腹部左下腹伤口插入异物后,出现了持续三个月的左下腹痛。影像学评估显示存在异物。剖腹探查发现其乙状结肠中有两个金属异物和三个木质异物,且乙状结肠有一个洞,被大网膜紧密封闭。异物被成功取出,洞被一期缝合,患者顺利出院。
该病例表明,精神科患者可通过自我伤害的伤口将异物插入结肠,且患者可能在数月后才出现症状,而未发展为弥漫性腹膜炎。