Ma Tantan, Zheng Wentao, An Beiying, Xia Yan, Chen Geng
Department of Gastroenterology, The First Hospital of Jilin University, Changchun.
Zhenlai County People's Hospital, Baicheng, Jilin, China.
Medicine (Baltimore). 2019 Jul;98(30):e16489. doi: 10.1097/MD.0000000000016489.
Foreign body ingestion is often encountered in clinical practice; however, intestinal perforation owing to foreign body ingestion is rare.
Here, we present the cases of 2 patients who accidentally swallowed foreign bodies and later presented with pain in the right lower abdominal quadrant.
Both patients were initially diagnosed with acute appendicitis and underwent immediate emergency laparotomy.
During the operation, the appendix was found to be only mildly inflamed. On transection of the appendix, the mucosa was found to be inflamed, and yellow-white exudate was noted. We, therefore, decided to explore the entire bowel. The bowel examination revealed small bowel perforations, and palpation of the adjacent bowel revealed a hard, sharp object. The object was removed through the perforation site, the perforation was repaired, and the abdomen was closed in layers.
The postoperative recovery, in both cases, was uneventful.
Patients who swallow sharp or large foreign bodies should undergo endoscopy as soon as possible to avoid intestinal perforation. Clinicians should inquire about a history of foreign body ingestion. The preoperative diagnosis of intestinal perforation secondary to foreign body ingestion requires a high degree of clinical suspicion and awareness.
临床实践中经常会遇到异物摄入的情况；然而，因异物摄入导致的肠道穿孔却很罕见。
在此，我们报告2例意外吞食异物且随后出现右下腹疼痛的患者病例。
两名患者最初均被诊断为急性阑尾炎，并立即接受了急诊剖腹手术。
手术过程中，发现阑尾仅有轻度炎症。切开阑尾后，发现黏膜发炎，并可见黄白色渗出物。因此，我们决定探查整个肠道。肠道检查发现小肠穿孔，触诊相邻肠道时发现一个坚硬、尖锐的物体。通过穿孔部位取出该物体，修复穿孔，然后分层缝合腹部。
两例患者术后恢复均顺利。
吞食尖锐或大型异物的患者应尽快接受内镜检查，以避免肠道穿孔。临床医生应询问异物摄入史。异物摄入继发肠道穿孔的术前诊断需要高度的临床怀疑和警觉。
