Kanamalla Karthik, Salamone Frank J, Vargas Jose
Frank H. Netter MD School of Medicine, Quinnipiac University, 370 Bassett Rd, North Haven, CT 06473, USA.
St. Vincent's Medical Center, 2800 Main St, Bridgeport, CT 06606, USA.
Ann Med Surg (Lond). 2021 Jul 30;68:102650. doi: 10.1016/j.amsu.2021.102650. eCollection 2021 Aug.
Diverticular perforation due to foreign body ingestion is an uncommon but important cause of gastrointestinal tract injury. The aim of this study is to discuss relevant findings seen in diverticulitis caused by foreign bodies and its treatment.
In this report, we present a case of a 30-year-old woman who presented to the emergency department with two days of severe abdominal pain and diarrhea. Computed tomography of the patient's abdomen and pelvis revealed micro-perforations of the sigmoid colon with pneumoperitoneum and an intraluminal foreign body. She subsequently underwent an exploratory laparotomy with sigmoid resection and end-to-end anastomosis due to acute diverticulitis complicated by feculent peritonitis. Gross examination of the excised specimen revealed two large perforations and an intraluminal chicken bone. After a six-day hospitalization, the patient was discharged with an excellent prognosis.
Prompt radiological evaluation and classification of the degree of diverticulitis using the Hinchey classification system in this patient helped guide definitive treatment. Usage of this classification scheme in foreign body diverticulitis is valuable in determining whether a surgical or non-surgical approach is necessary.
因异物摄入导致的憩室穿孔是胃肠道损伤的一种罕见但重要的原因。本研究的目的是探讨异物所致憩室炎的相关表现及其治疗方法。
在本报告中，我们呈现了一名30岁女性的病例，她因两天的严重腹痛和腹泻就诊于急诊科。患者腹部和盆腔的计算机断层扫描显示乙状结肠微穿孔伴气腹和腔内异物。由于急性憩室炎并发粪性腹膜炎，她随后接受了剖腹探查术，行乙状结肠切除术和端端吻合术。切除标本的大体检查发现两个大穿孔和腔内一根鸡骨。经过六天的住院治疗，患者出院，预后良好。
对该患者使用欣奇分类系统进行及时的影像学评估和憩室炎程度分类有助于指导确定性治疗。在异物性憩室炎中使用该分类方案对于确定是否需要手术或非手术方法很有价值。
