Takasu Ayaka, Ikeya Takashi, Fukuda Katsuyuki
Department of Gastroenterology, St. Luke's International Hospital, Tokyo, Japan.
Case Rep Gastroenterol. 2021 Feb 3;15(1):137-141. doi: 10.1159/000511751. eCollection 2021 Jan-Apr.
The incidence of press-through pack (PTP) ingestion has been increasing. In many cases, the ingested PTP is lodged in the esophagus. Here, we report a case of endoscopic removal of a PTP from the anal canal. An 89-year-old man with mild dementia presented with a 3-day history of anal pain. On digital rectal examination, we felt a hard and sharp object, which could not be manually removed due to its shape. Therefore, it was removed endoscopically. We inserted an endoscope with a large-caliber soft oblique cap and observed the PTP in the anal canal. It was successfully removed using grasping forceps. The patient was stable, with only mild anal fissures, and no serious complications such as perforation and bleeding were observed. It is generally recognized that a PTP that reaches the large intestine is naturally expelled. Even if a PTP could pass through the pylorus or the small intestine, it could still be difficult to discharge naturally from the anus without discomfort or pain, as in this case.
压穿包装（PTP）摄入的发生率一直在上升。在许多情况下，摄入的PTP会滞留在食管中。在此，我们报告一例经内镜从肛管取出PTP的病例。一名患有轻度痴呆的89岁男性，出现了3天的肛门疼痛病史。在直肠指检时，我们摸到了一个坚硬且尖锐的物体，因其形状无法手动取出。因此，通过内镜将其取出。我们插入了带有大口径软斜帽的内镜，并在肛管中观察到了PTP。使用抓钳成功将其取出。患者情况稳定，仅有轻度肛裂，未观察到穿孔和出血等严重并发症。一般认为，到达大肠的PTP会自然排出。即使PTP能够通过幽门或小肠，也可能像本例一样，难以毫无不适或疼痛地从肛门自然排出。
