Wang Zhihui, Du Zhiqiang, Zhou Xiangrong, Chen Tianming, Li Chunyan
Department of Gastroenterology, Jianyang People's Hospital, No. 180 Yiyuan Road, Jianyang City, 641400, China.
BMC Gastroenterol. 2020 Jul 23;20(1):236. doi: 10.1186/s12876-020-01335-7.
The induction of chronic inflammation, perforation, and abscess by foreign bodies (FBs) in adults is uncommon. We present a delayed diagnosis case for a patient who had a fishbone stuck in the duodenal bulb, resulting in chronic abdominal pain for nearly 3 months. We present the diagnosis and treatment procedures for chronic patients, which differ from those for acute and emergency FB ingestion, and also summarize the characteristics of such patients through a systematic literature review.
A 68-year-old woman was brought to our hospital with repeated right upper abdominal pain lasting for 3 months and aggravation for 9 h. Computed tomography (CT) showed a streaky high-density shadow (approximately 3 cm in length) on the posterior wall of the gastric antrum extending outside the wall. Endoscopic ultrasonography showed hyperechoic space with a cross-section of approximately 0.1 × 0.1 cm in the deep submucosal layer of the local stomach, accompanied by an acoustic shadow in the rear. The possibility of a fishbone as well as perforation was considered and the object was removed using FB forceps. Fasting as well as acid inhibition and anti-infection medication were prescribed for the patient. She eventually recovered and was discharged from the hospital.
Endoscopic intervention can be recommended as the first option for patients with gastrointestinal FBs.
异物在成人中引发慢性炎症、穿孔和脓肿的情况并不常见。我们报告一例十二指肠球部鱼骨嵌顿导致慢性腹痛近3个月的患者的延迟诊断病例。我们介绍了慢性患者的诊断和治疗程序，这些程序与急性和急诊异物摄入的程序不同，并通过系统的文献综述总结了此类患者的特征。
一名68岁女性因反复右上腹疼痛3个月、加重9小时被送至我院。计算机断层扫描（CT）显示胃窦后壁有一条条纹状高密度影（约3厘米长）延伸至壁外。内镜超声显示局部胃黏膜深层有一个横断面约0.1×0.1厘米的高回声间隙，后方伴有声影。考虑到鱼骨以及穿孔的可能性，使用异物钳取出了异物。为患者开了禁食以及抑酸和抗感染药物。她最终康复出院。
对于胃肠道异物患者，可推荐内镜干预作为首选治疗方法。
