Yacoub Wael, Douira-Khomsi Wiem, Louati Hela, Lahmar Lilia, Ben Hassine Lilia, Nouira Faouzi, Jlidi Said, Bellagha Ibtissem
Tunis Med. 2018 May;96(5):314-316.
Foreign body ingestion is a frequent issue in paediatrician's practice. Foreign bodies often pass the gastro-intestinal tract spontaneously but can sometimes generate complications (1% of the cases). The migration of ingested foreign bodies is rare, but their spontaneous extrusion through the skin is even rarer and was previously described only in the neck. We report an unusual case of a spontaneous extrusion of an ingested foreign body through the skin of the lower abdomen. Observation: A 2 year-old boy, presented with a 2cm inflammatory swelling of the hypogastric region. Laboratory analysis showed hyperleukocytosis (16 7770 /mm3) and high C reactive protein level at 12mg/L. Ultrasonography and computed tomography allowed us to diagnose a parietal foreign body extruding through the skin and to eliminate associated complication (perforation, vascular fistula…). The foreign body was extracted by a surgical incision. This observation is very rare but it is also uncommon because of the nature of the ingested foreign body which was a wooden piece. Its ingestion was explained by a paediatric mental disorder.
异物摄入是儿科医生临床工作中常见的问题。异物通常可自行通过胃肠道，但有时会引发并发症（发生率为1%）。摄入异物的迁移很少见，而异物自行经皮肤排出则更为罕见，此前仅在颈部有过相关报道。我们报告一例罕见病例，摄入的异物经下腹皮肤自行排出。病例观察：一名2岁男孩，下腹区域出现2厘米的炎性肿胀。实验室分析显示白细胞增多（167770/mm³），C反应蛋白水平升高至12mg/L。超声检查和计算机断层扫描使我们诊断出有一个异物经皮肤穿出腹壁，并排除了相关并发症（穿孔、血管瘘等）。通过手术切口取出了异物。该病例非常罕见，而且由于摄入的异物是一块木头，这种情况也不常见。其摄入异物的行为被解释为患有儿童精神障碍。
