Beh Joey Chan Yiing, Uppaluri Anandswaroop Srinivas, Koh Beatrice Fang Ju, Cheow Peng-Chung
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Department of Hepato-Pancreato-Biliary/Transplant Surgery, Singapore General Hospital, Singapore.
J Radiol Case Rep. 2016 Jul 31;10(7):14-22. doi: 10.3941/jrcr.v10i7.2826. eCollection 2016 Jul.
Ingested foreign bodies tend to pass through the gastrointestinal tract without incidence, and vast majority of cases do not need intervention. Rarely, these foreign bodies drop into the appendix and not likely to re-enter the normal digestive tract. We describe a case of a 72-year-old male patient who presented with right iliac fossa pain of 3-day duration. Clinical examination suggested classic acute appendicitis. Blood test results revealed leukocytosis. Computed tomography of the abdomen and pelvis showed evidence of acute appendicitis and a linear hyperdensity (foreign body) perforating the appendix. The patient was managed successfully with prompt laparoscopic appendectomy and removal of the foreign body which was confirmed to be a fish bone measuring about 10mm. While imaging diagnosis of fishbone in the appendix has been published, reports are few. To the best of the author's knowledge, fishbone induced perforated appendicitis has been described only in 2 cases (including this case) in the literature.
摄入的异物通常会顺利通过胃肠道,绝大多数情况下无需干预。极少数情况下,这些异物会掉入阑尾,且不太可能重新进入正常消化道。我们报告一例72岁男性患者,其右侧髂窝疼痛持续3天。临床检查提示典型的急性阑尾炎。血液检查结果显示白细胞增多。腹部和盆腔计算机断层扫描显示有急性阑尾炎的迹象以及一个穿透阑尾的线性高密度影(异物)。患者通过及时的腹腔镜阑尾切除术及取出异物成功治愈,异物经证实为一根约10毫米的鱼骨。虽然已有关于阑尾内鱼骨的影像学诊断报道,但数量较少。据作者所知,文献中仅描述了2例(包括本例)鱼骨导致的穿孔性阑尾炎。