Greene Brittany, Jones Daniel, Sarrazin Josée, Coburn Natalie G
Division of General Surgery, University of Toronto, Toronto, Ontario, Canada.
Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
BMJ Case Rep. 2019 Apr 8;12(4):e227271. doi: 10.1136/bcr-2018-227271.
A man in his late 50s presented to the emergency room with a 1-month history of severe abdominal pain and an endoscopic fishbone retrieval from his rectum. Serial CT scans revealed a fishbone located in the patient's upper abdomen, which had migrated through the stomach wall, into the periportal space, causing a contained gastric perforation, development of a porta hepatis abscess and secondary portal vein thrombosis. Furthermore, the sharp tip of the fishbone lay 5 mm from the patient's hepatic artery. He was transferred to a hepatobiliary centre where he underwent urgent exploratory laparotomy, with surgical exploration of the porta, drainage of the abscess and retrieval of the fishbone. Postoperatively, he received further treatment with antibiotics and anticoagulation and recovered without further sequelae.
一名50多岁的男性因严重腹痛1个月并经内镜从直肠取出鱼骨而就诊于急诊室。系列CT扫描显示，一根鱼骨位于患者上腹部，已穿过胃壁进入肝门周围间隙，导致局限性胃穿孔、肝门脓肿形成及继发性门静脉血栓形成。此外，鱼骨尖锐的一端距离患者肝动脉仅5毫米。他被转至肝胆中心，在那里接受了紧急剖腹探查术，对肝门进行了手术探查、脓肿引流及鱼骨取出。术后，他接受了抗生素及抗凝进一步治疗，康复且无进一步后遗症。
