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腹腔镜成功治疗鱼骨迁移至胰颈部所致持续性腹痛:1例报告及文献复习对手术入路的思考

Successful laparoscopic treatment for sustained abdominal pain due to fish bone migrating into the neck of the pancreas: a case report and thinking about surgical approach through the literature review.

作者信息

Wang Yang, Luo Xianzhang, Zhang Jiefeng

机构信息

Hepatic Biliary and Pancreatic Cancer Center, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba, Chongqing, 400030, People's Republic of China.

出版信息

Surg Case Rep. 2021 Apr 13;7(1):91. doi: 10.1186/s40792-021-01174-y.

Abstract

BACKGROUND

The majority of ingested foreign bodies pass through the gastrointestinal tract smoothly, with less than 1% requiring surgery. Fish bone could perforate through the wall of stomach or duodenum and then migrate to other surrounding organs, like the pancreas and liver.

CASE PRESENTATION

We report herein the case of a 67-year-old male who presented with sustained mild epigastric pain. Abdominal computed tomography revealed a linear, hyperdense, foreign body along the stomach wall and pancreatic neck. We made a final diagnosis of localized inflammation caused by a fish bone penetrating the posterior wall of the gastric antrum and migrating into the neck of the pancreas. Upper gastrointestinal endoscopy was performed firstly, but no foreign body was found. Hence, a laparoscopic surgery was performed. The foreign body was removed safely in one piece and was identified as a 3.2-cm-long fish bone. The patient was discharged from the hospital on the fifth day after surgery without any postoperative complications.

CONCLUSION

Laparoscopic surgery has proven to be a safe and effective way to remove an ingested fish bone embedded in the pancreas.

摘要

背景

大多数摄入的异物可顺利通过胃肠道,不到1%的患者需要手术治疗。鱼骨可能会穿透胃或十二指肠壁,然后迁移至周围其他器官,如胰腺和肝脏。

病例介绍

我们在此报告一例67岁男性患者,其表现为持续性轻度上腹部疼痛。腹部计算机断层扫描显示沿胃壁和胰颈部有一线状、高密度异物。我们最终诊断为由鱼骨穿透胃窦后壁并迁移至胰颈部引起的局限性炎症。首先进行了上消化道内镜检查,但未发现异物。因此,进行了腹腔镜手术。异物被安全完整地取出,经鉴定为一根3.2厘米长的鱼骨。患者术后第五天出院,无任何术后并发症。

结论

腹腔镜手术已被证明是一种安全有效的方法,可用于取出嵌入胰腺的摄入鱼骨。

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