Kanazawa Ayako, Kamezaki Fumihiko, Kido Takashi, Yamasaki Seigen, Someya Kazuki, Takama Tatsuo, Otsubo Hiroki, Yoshikawa Ichiro, Kamochi Masayuki, Mayumi Toshihiko
Department of Emergency Medicine University of Occupational and Environmental Health Kitakyushu Japan.
Intensive Care Unit University of Occupational and Environmental Health Hospital Kitakyushu Japan.
Acute Med Surg. 2014 Nov 7;2(3):195-198. doi: 10.1002/ams2.90. eCollection 2015 Jul.
An 88-year-old female with Alzheimer's-type dementia who mis-swallowed a press-through package visited our emergency department.
Plain radiography detected no foreign bodies, whereas plain computed tomography showed an elliptical body with a high density in the lower esophagus. The press-through package containing a tablet in the esophagogastric junction was successfully removed without severe complications using the endoscopic protector hood. In cases of press-through package mis-swallowing, it is important for emergency physicians to make an early and correct diagnosis of the location of the package, which shows high radiolucency. Based on the results of this case, we hypothesize that carrying out early computed tomography examinations is useful for identifying swallowed press-through packages. Our retrospective investigation showed that computed tomography has a sensitivity of 100% for detecting press-through packages.
We experienced a case of press-through package mis-swallowing diagnosed on computed tomography. We recommend performing computed tomography examinations, especially in patients with an uncertain history and unclear symptoms.
一名88岁患有阿尔茨海默病型痴呆的女性误吞了一个泡罩包装，前来我院急诊科就诊。
X线平片未发现异物，而普通计算机断层扫描显示食管下段有一个高密度椭圆形物体。使用内镜保护罩成功取出了位于食管胃交界处、装有一片药片的泡罩包装，未出现严重并发症。在误吞泡罩包装的病例中，对于急诊医生来说，早期正确诊断泡罩包装的位置非常重要，因为其射线透过性高。基于该病例结果，我们推测早期进行计算机断层扫描检查有助于识别误吞的泡罩包装。我们的回顾性调查显示，计算机断层扫描检测泡罩包装的灵敏度为100%。
我们遇到了一例通过计算机断层扫描诊断出的误吞泡罩包装病例。我们建议进行计算机断层扫描检查，尤其是对于病史不明和症状不明确的患者。
