Riva Carlo Galdino, Toti Francesco Angelo Taddàus, Siboni Stefano, Bonavina Luigi
Department of Surgery, IRCCS Policlinico San Donato, Università degli Studi di Milano, Milano, Italy.
BMJ Case Rep. 2018 Jun 27;2018:bcr-2018-225241. doi: 10.1136/bcr-2018-225241.
Foreign body ingestion is a common event; in the adult population, most ingestions occur in patients with mental disability, psychiatric disorders, alcohol intoxication or in prisoners seeking secondary gain. Removal through flexible endoscopy is generally the first-line approach but rescue oesophagotomy may be necessary for foreign bodies impacted in the upper oesophagus. A 27-year-old man was admitted in the emergency room after intentional ingestion of a wooden spherical object with a central hole. A total body CT scan showed that the object was completely obstructing the upper oesophageal lumen but there were no signs of perforation. In the operating room, a Weerda diverticuloscope and a 5 mm 0° telescope were used to visualise the foreign body under general anaesthesia. A standard endoscopic biopsy forceps was passed through the hole of the sphere and was retracted with the jaws open allowing transoral extraction without complications.
异物摄入是一种常见情况;在成年人群中,大多数摄入事件发生在有智力残疾、精神疾病、酒精中毒的患者或寻求继发利益的囚犯身上。通过软性内镜取出通常是一线方法,但对于嵌顿在上段食管的异物,可能需要进行挽救性食管切开术。一名27岁男子在故意摄入一个带有中心孔的木制球形物体后被送入急诊室。全身CT扫描显示该物体完全阻塞了上段食管腔,但没有穿孔迹象。在手术室,使用韦尔达憩室镜和5毫米0°望远镜在全身麻醉下观察异物。将标准的内镜活检钳穿过球体的孔,然后张开钳口将其缩回,经口取出,未出现并发症。