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腹中锐器:急诊科小儿故意吞食剃须刀片一例

Sharp Object in the Belly: A Case of Pediatric Intentional Razor Blade Ingestion in the Emergency Department.

作者信息

Carius Brandon M, Dodge P M, Long Brit

机构信息

Emergency Medicine, Brian D. Allgood Army Community Hospital, Camp Humphreys, KOR.

Prehospital Medicine, University of New Hampshire, Manchester, USA.

出版信息

Cureus. 2020 Apr 16;12(4):e7699. doi: 10.7759/cureus.7699.

Abstract

Ingested foreign object (FOB) is a common complaint in the emergency department (ED), especially in pediatric patients. While many FOB ingestions are benign, sharp objects, including razor blades, are of particular concern given the acute risk of perforation throughout the gastrointestinal tracts. The majority of razor blade ingestions involve prisoners and psychiatric patients, which can complicate the diagnosis and treatment. Although literature suggests that risks of perforation and complication may be high, limited research available on sharp FOB ingestions supports a general non-interventional strategy. Instead, close follow-up and serial radiographs for natural passage are recommended for the majority of cases. We highlight the case of a 17-year-old female who presented to the ED for suspected FOB ingestion and was found to have a singular 3.0 x 0.5 cm razor blade on abdominal radiograph following an unremarkable initial evaluation. In line with prior literature, surgical consult supported natural passage with serial radiographs, and the patient was subsequently discharged home with a recommended bulk food diet.

摘要

吞食异物(FOB)是急诊科(ED)常见的就诊原因,尤其是在儿科患者中。虽然许多吞食异物的情况是良性的,但包括剃须刀片在内的尖锐物体,鉴于其在整个胃肠道穿孔的急性风险,尤其令人担忧。大多数剃须刀片吞食事件涉及囚犯和精神病患者,这可能会使诊断和治疗变得复杂。尽管文献表明穿孔和并发症的风险可能很高,但关于尖锐异物吞食的现有研究有限,支持一般的非干预策略。相反,对于大多数病例,建议密切随访并进行系列X光检查以观察异物自然排出。我们重点介绍了一名17岁女性的病例,她因疑似吞食异物到急诊科就诊,在初步评估无异常后,腹部X光片显示有一片3.0×0.5厘米的剃须刀片。与先前的文献一致,外科会诊支持通过系列X光检查观察异物自然排出,患者随后出院并被建议食用高纤维食物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a71/7233514/0d3cbccb1418/cureus-0012-00000007699-i01.jpg

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