Rodriguez Juan Eduardo Rios, Coelho Daniella Paula Dias, Villalaz Edirany Dos Santos, Figueiredo Alberto Rubin, Martins Paulo Daumas Kale, Guimarães José Jorge Pinheiro, de Souza Aline Morião Carvalho, Guimarães Adriana Gonçalves Daumas Pinheiro
Departament of General Surgery, Getúlio Vargas University Hospital (HUGV), Manaus, Brazil.
Departament of Radiology, Amazonas State Foundation Oncology Control Center (FCECON), Manaus, Brazil.
Ann Med Surg (Lond). 2021 Sep 27;70:102897. doi: 10.1016/j.amsu.2021.102897. eCollection 2021 Oct.
Foreign body ingestion is a common clinical scenario found in clinical practice. Perforations related to foreign bodies are rare, but they can present as a serious condition in emergency surgery services. The most common sites of perforation are angled areas, such as: ileocecal valve, sigmoid colon, duodenojejunal flexure and small intestine. We are going to describe a rare case of extensive perforation of rectosigmoid transition, without associated obstructive clinical picture, related to voluntary ingestion of foreign body caused by multiple seeds of a typical amazon fruit.
This case report describes the presentation and management of a 46-year-old man who presented signs of acute perforating abdomen, without obstructive condition, after ingestion of foreign body. Imaging examination revealed the presence of foreign bodies with signs of intestinal perforation. Exploratory laparotomy was performed to treat the lesion and remove foreign bodies.
Bowel perforation by a non-sharp foreign body is a rare complication of object ingestion. Object shape, quantity, narrowing of gastrointestinal tract are factors that can favor perforation. The clinic is not very specific, usually preceded by when obstructive or sub occlusive, and the clinical history is relevant for diagnostic formulation. Regions and cultures with a high intake of food with seeds may constitute an extra risk factor.
The importance of alerting surgical teams to the possibility of bowel perforation without associated occlusive conditions caused by multiple non-sharp seeds is highlighted, as well as the need for early treatment aiming at favorable clinical outcome.
异物摄入是临床实践中常见的临床情况。与异物相关的穿孔很少见,但在急诊手术中可能是严重情况。最常见的穿孔部位是有角度的区域,如:回盲瓣、乙状结肠、十二指肠空肠曲和小肠。我们将描述一例罕见的直肠乙状结肠移行部广泛穿孔病例,无相关梗阻临床表现,与自愿摄入一种典型亚马逊水果的多颗种子所致异物有关。
本病例报告描述了一名46岁男性在摄入异物后出现急性穿孔性腹部体征但无梗阻情况的表现及治疗过程。影像学检查发现有异物及肠道穿孔迹象。进行了剖腹探查术以治疗病变并取出异物。
非尖锐异物导致的肠道穿孔是异物摄入的罕见并发症。异物形状、数量、胃肠道狭窄是可能导致穿孔的因素。临床表现不太特异,通常在出现梗阻或亚梗阻之前出现,临床病史对诊断形成很重要。种子类食物摄入量高的地区和文化可能构成额外的危险因素。
强调提醒外科团队注意由多颗非尖锐种子导致无相关梗阻情况的肠道穿孔的可能性,以及为获得良好临床结果进行早期治疗的必要性。