Guo Xiaoshuang, Lai Shicong, Chen Haixin, Tian Meice, Zhang Guan
16th Department, Plastic Surgery Hospital Peking Union Medical College, Chinese Academy of Medical Sciences Peking University China-Japan Friendship School of Clinical Medicine Department of Urology, China-Japan Friendship Hospital Department of Cardiovascular Surgery, Fuwai Hospital National Center for Cardiovascular Diseases (NCCD), Beijing, China.
Medicine (Baltimore). 2017 Dec;96(49):e8943. doi: 10.1097/MD.0000000000008943.
Foreign body ingestion is a common presentation in the emergency room. However, the complication such as penetrating renal trauma due to sharp objects ingestion is relatively rare. We herein describe an unusual case of penetrating renal trauma in the absence of any other urinary symptoms. A 53-year-old man who had a history of iron wire ingestion went to our hospital, on examination, he only had slight abdominal tenderness due to swallowing a ball pen and 1 cap nut 1 day before, radiological imaging showed penetrating renal trauma, the blood test showed his renal function is normal. Surgical strategies were recommended to remove the pen and the iron wire simultaneously, nonetheless the patient eventually agreed to only receive surgical removal of the swallowed ball pen and cap nut, meanwhile leave the kidney untreated. During 30 months follow-up by phone and regular outpatient examination, he recovered unevenly and had no special complaint. Such cases remind us that chronic penetrating renal trauma due to foreign object ingestion may have no obvious symptoms. It is easily to be neglected. We should try to minimize the possibility of missed lesions by adhering to a meticulous examination technique.
异物摄入是急诊室的常见症状。然而,因摄入尖锐物体导致穿透性肾外伤等并发症相对少见。我们在此描述一例无任何其他泌尿系统症状的穿透性肾外伤罕见病例。一名有吞食铁丝病史的53岁男性到我院就诊,检查发现他因1天前吞食一支圆珠笔和1个螺帽仅伴有轻微腹部压痛,影像学检查显示为穿透性肾外伤,血液检查显示其肾功能正常。建议采取手术策略同时取出笔和铁丝,但患者最终同意仅接受手术取出吞食的圆珠笔和螺帽,同时不对肾脏进行处理。在通过电话和定期门诊检查进行的30个月随访中,他恢复情况不一,无特殊主诉。此类病例提醒我们,异物摄入导致的慢性穿透性肾外伤可能没有明显症状,很容易被忽视。我们应通过坚持细致的检查技术尽量减少漏诊病变的可能性。