Principe Daniel R, Rubin Jonathan, Narbutis Matt, Cabrera Julio, Mitsiev Ivo
Medical Scientist Training Program, University of Illinois College of Medicine, Chicago IL, USA.
University of Illinois, Metropolitan Group Hospitals General Surgery Residency, Advocate Illinois Masonic Hospital, Chicago IL, USA.
J Surg Case Rep. 2019 Apr 24;2019(4):rjz121. doi: 10.1093/jscr/rjz121. eCollection 2019 Apr.
Irretrievable rectal foreign bodies can cause significant distress and generally require emergency medical attention. While smaller objects can often be removed trans-anally, larger objects typically require more invasive intervention. Here, we report the case of a 57-year-old man who had previously presented to the emergency department with a baseball lodged in the rectosigmoid that required a laparotomy. One year later, he represented with a significantly larger object also affixed in the rectosigmoid. Exploratory laparotomy revealed an edematous, inflamed bowel with extensive adhesions from the pervious surgery. Given the degree of tissue damage and large size of the object, the decision was made to perform a Hartmann's procedure. The object, an 11 × 10 cm rubber chew toy, was successfully removed and the patient was referred to the appropriate mental health professionals during follow-up.
无法取出的直肠异物会造成极大痛苦,通常需要紧急医疗处理。较小的物体往往可以经肛门取出,而较大的物体通常需要更具侵入性的干预措施。在此,我们报告一例57岁男性病例,该患者此前因一枚卡在直肠乙状结肠处的棒球而到急诊科就诊,当时需要进行剖腹手术。一年后,他又因一枚同样卡在直肠乙状结肠处的大得多的物体前来就诊。 exploratory laparotomy显示肠道水肿、发炎,且有上次手术造成的广泛粘连。鉴于组织损伤程度和物体尺寸较大,决定实施哈特曼手术。该物体是一个11×10厘米的橡胶咀嚼玩具,已成功取出,患者在随访期间被转介给了合适的心理健康专业人员。