腹腔镜处理酷似肝肿瘤的肝内游走鱼骨：1例报告及文献复习
Laparoscopic management of enterohepatic migrated fish bone mimicking liver neoplasm: A case report and literature review.
作者信息
Chen Jun, Wang Chao, Zhuo Jianyong, Wen Xue, Ling Qi, Liu Zhikun, Guo Haijun, Xu Xiao, Zheng Shusen
机构信息
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
出版信息
Medicine (Baltimore). 2019 Mar;98(11):e14705. doi: 10.1097/MD.0000000000014705.
RATIONALE
Accidental ingestion of a foreign body is common in daily life. But the hepatic migration of perforated foreign body is rather rare.
PATIENT CONCERNS
A 37-year-old man presented with a history of vague epigastric discomfort for about 2 months.
DIAGNOSIS
A diagnosis of the foreign body induced hepatic inflammatory mass was made based on abdominal computed tomographic scan and upper gastrointestinal endoscopy.
INTERVENTIONS
The patient underwent laparoscopic laparotomy. During the operation, inflammatory signs were seen in the lesser omentum and segment 3 of liver. B- Ultrasound guided excision of the mass (in segment 3) was performed. Dissecting the specimen revealed a fish bone measuring 1.7 cm in length.
OUTCOMES
The patient recovered uneventfully and was discharged on day 5 after surgery.
LESSONS
This study shows the usefulness of endoscopy for final diagnosis and treatment in foreign body ingestion. Early diagnosis and decisive treatment in time are lifesaving for patients with this potentially lethal condition.
理论依据
日常生活中意外摄入异物很常见。但穿孔异物向肝脏迁移相当罕见。
患者情况
一名37岁男性，有大约2个月的上腹部隐痛病史。
诊断
根据腹部计算机断层扫描和上消化道内镜检查，诊断为异物所致肝脏炎性肿块。
干预措施
患者接受了腹腔镜剖腹手术。术中发现小网膜和肝3段有炎症迹象。在B超引导下切除了肝3段的肿块。解剖标本发现一根长1.7厘米的鱼骨。
结果
患者恢复顺利，术后第5天出院。
经验教训
本研究表明内镜检查在异物摄入的最终诊断和治疗中有用。对于这种潜在致命疾病的患者，早期诊断并及时果断治疗可挽救生命。
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