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缝针导致嵌顿性腹股沟疝并发回盲部穿孔:一例罕见病例报告

Ileocecal junction perforation caused by a sewing needle in incarcerated inguinal hernia: An unusual case report.

作者信息

Liu Shiqi, Li Qifeng, Li Yumei, Lv Yi, Niu Jianhua, Xu Quan, Zhao Jingru, Chen Yajun, Wang Dayong, Bai Ruimiao

机构信息

Department of Pediatric Surgery, Northwest Women's and Children's Hospital, Xi'an, Shaanxi Province Xinjiang Institute of Pediatrics, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, P.R. China The Interdisciplinary Centre for Security, Reliability and Trust (Sn T), University of Luxembourg, Luxembourg, Luxembourg Department of Hepatobiliary Surgery, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shanxi Province Third Department of General Surgery, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, Xinjiang Department of Basic Surgery, Beijing Children's Hospital, Capital Medical University, Beijing Department of Neonatal Intensive Care Unit, Northwest Women's and Children's Hospital, Xi'an, Shaanxi Province, P.R. China.

出版信息

Medicine (Baltimore). 2018 Jun;97(22):e10787. doi: 10.1097/MD.0000000000010787.

Abstract

INTRODUCTION

This case study is concerning the meticulous observation of the moving process and track of 2 ingested needles using interval x-ray radiography, trying to localize the foreign bodies and reduce unnecessary exploration of digestive tract.

CASE PRESENTATION

An unusual case of a 1-year, 9-month-old female baby, with incarcerated hernia perforation caused by sewing needles with sharp ends, was reported herein. The patient had swallowed 2 sewing needles. One needle was excreted uneventfully after 8 days. On the contrary, the other needle stabbed the ileocecal junction wall into the right side of inguinal hernia sac after 9 days, and the patient received successful operation management. Interval x-ray confirmed that 1 needle-like foreign body moving down in 8 days until excretion along with feces. However, the other pierced into the incarcerated hernia. Preoperative x-ray radiography successfully monitored the moving process and tract of the sewing needles. Considering the penetrating-migrating nature of the foreign bodies, once the sharp-pointed objects were located, they should be removed as the mortality and risk of related complications may be increased.

CONCLUSION

Interval x-ray radiography represents a meticulous preoperative monitoring method of the moving process and tract of needle-like foreign bodies. Interval x-ray with real-time images accurately detecting the moving foreign bodies could be help to reduce the unnecessary exploration of digestive tract and subsequently prevent possible complications. Based on the basic findings from the interval x-ray, treatment choices of endoscopic removal and surgical intervention may be attempted.

摘要

引言

本病例研究涉及使用间隔X线摄影术对2根摄入针的移动过程和轨迹进行细致观察,旨在定位异物并减少对消化道的不必要探查。

病例报告

本文报道了一例罕见病例,一名1岁9个月大的女婴,因尖锐末端的缝纫针导致嵌顿疝穿孔。该患者吞下了2根缝纫针。一根针在8天后顺利排出。相反,另一根针在9天后刺入回盲部肠壁进入腹股沟疝囊右侧,患者接受了成功的手术治疗。间隔X线检查证实,一根针状异物在8天内向下移动直至随粪便排出。然而,另一根刺入了嵌顿疝。术前X线摄影成功监测了缝纫针的移动过程和轨迹。考虑到异物的穿透迁移特性,一旦定位到尖锐物体,应将其取出,因为相关并发症的死亡率和风险可能会增加。

结论

间隔X线摄影术是一种对针状异物移动过程和轨迹进行细致术前监测的方法。具有实时图像的间隔X线准确检测移动异物有助于减少对消化道的不必要探查,从而预防可能的并发症。基于间隔X线的基本发现,可以尝试内镜取出和手术干预等治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8e7/6393046/59ed7f434b51/medi-97-e10787-g001.jpg

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