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直肠异物:床边成功取出及详细分步处理

Rectal Foreign Body: A Successful Removal at the Bedside and Detailing of a Stepwise Management.

机构信息

Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia.

Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Center, Cheras, Kuala Lumpur, Malaysia.

出版信息

Am J Case Rep. 2021 Jun 17;22:e930967. doi: 10.12659/AJCR.930967.

DOI:10.12659/AJCR.930967
PMID:34135299
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8218603/
Abstract

BACKGROUND A rectal foreign body (RFB) can be stigmatizing for patients and present a dilemma for the treating physician. Removal can be challenging owing to the variety of objects introduced. The goals of therapy are to safely remove the RFB and to minimize injury to the bowel. CASE REPORT A 22-year-old man was referred from a district hospital to our institution after being unable to remove a self-inflicted RFB after sexual gratification. He was hemodynamically stable with a soft and nontender abdomen. A mass was felt in the suprapubic region. Abdominal radiography revealed a well-defined radiolucent object in the pelvic region, which was consistent with a lubricant bottle. No sign of bowel obstruction or perforation was observed. The RFB was successfully retrieved by a combination of transrectal digital manipulation and directed gentle abdominal pressure, allowing for descent of the RFB and transanal traction at the bedside. Various approaches have been described for removal of a RFB, from simple bedside strategies to open surgery for complicated cases. Endoscopy and minimally invasive techniques have also demonstrated a role in formulating a tailored approach. CONCLUSIONS We describe a successful retrieval of an RFB at the bedside, avoiding unnecessary open surgery.

摘要

背景

直肠异物(RFB)可能会令患者感到尴尬,并给治疗医生带来困境。由于引入的物体种类繁多,取出异物可能具有挑战性。治疗的目标是安全地取出 RFB 并将对肠道的损伤降到最低。

病例报告

一名 22 岁男子在性满足后无法自行取出自行插入的直肠异物,遂从地区医院转至我院。他血流动力学稳定,腹部柔软无压痛。耻骨上区域可触及肿块。腹部 X 线片显示骨盆区域有一个界限清楚的透亮物体,与润滑剂瓶一致。未观察到肠梗阻或穿孔的迹象。通过直肠内数字操作和定向轻柔腹部按压相结合,成功地取出了 RFB,使 RFB 下降并在床边进行经肛门牵引。已经描述了各种方法来取出 RFB,从简单的床边策略到复杂病例的开放性手术。内窥镜和微创技术也证明在制定个体化方法方面具有作用。

结论

我们描述了一种在床边成功取出 RFB 的方法,避免了不必要的开放性手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ed/8218603/e296869eab2f/amjcaserep-22-e930967-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ed/8218603/24f323e23f0d/amjcaserep-22-e930967-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ed/8218603/e296869eab2f/amjcaserep-22-e930967-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ed/8218603/24f323e23f0d/amjcaserep-22-e930967-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96ed/8218603/e296869eab2f/amjcaserep-22-e930967-g002.jpg

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