Kattula Dheeraj, Jiwanmall Stephen Amarjeet, Sekaran Balaji Srinivasa, Sharma Somanatha
Department of Psychiatry, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Surgery, Stanley Medical College, Chennai, Tamil Nadu, India.
J Family Med Prim Care. 2018 Sep-Oct;7(5):1093-1095. doi: 10.4103/jfmpc.jfmpc_132_18.
Patients with mental illness do not get medical and surgical attention as required. Here is a case of poor, unemployed gentleman with an ulcer which was carefully evaluated and treated appropriately. The presentation is novel in many other ways. The object of size 6 × 2.5 cm usually does not cross the duodenum, but in his case an 11-cm long pen had reached the splenic flexure. It also had stayed dormant for over 13 years before causing complications. When the pen perforated the bowel, the patient is expected to present with acute abdomen, but in this case it presented as enterocutaneus fistula. This case is first of its kind in medical literature.
患有精神疾病的患者无法获得所需的医疗和外科治疗。这里有一个案例，一位贫困、失业的绅士患有溃疡，经过仔细评估并得到了适当治疗。该病例在许多其他方面都很新颖。通常情况下，6×2.5厘米大小的异物不会穿过十二指肠，但在他的病例中，一支11厘米长的笔却到达了脾曲。而且它在引发并发症之前已经潜伏了13年多。当这支笔穿透肠道时，患者通常会表现为急腹症，但在这个病例中却表现为肠皮肤瘘。这种病例在医学文献中尚属首例。
