Scheppach Wolfgang, Hauschild Martin, Zwicker Martina, Konwisorz Anna, Schubring Markus, Reissmann Nikolaus
Medizinische Klinik mit Schwerpunkt Gastroenterologie/Rheumatologie, Standort Juliusspital, Klinikum Würzburg Mitte, Würzburg, Germany.
Zentrum für Seelische Gesundheit am König-Ludwig-Haus, Würzburg, Germany.
Z Gastroenterol. 2022 May;60(5):779-783. doi: 10.1055/a-1644-1823. Epub 2021 Nov 24.
Eight cases of young female patients with borderline personality disorder are reported. They presented between twice and 38 times for endoscopic extraction of ingested foreign bodies from the upper gastrointestinal tract. Thus, within a 3-year-period 265 foreign bodies were recovered at 143 endoscopies. Most frequently, spoon-handles of different lengths and broken fragments of china were extracted. Foreign bodies were almost always removed successfully and without complication. Only one knife firmly trapped between gastric fundus and antrum required a surgical gastrotomy. Depending on the type, size and number of the foreign bodies, the anticipated complexity of the endoscopic procedure and the reported fasting period approximately 40 percent of endoscopies were performed under airway protection by tracheal intubation. Despite considerable personal and material expenses most gastroenterologists, psychiatrists and surgeons advocate repeated foreign body extraction even in view of repetitive ingestion.
报告了8例边缘型人格障碍的年轻女性患者。她们因上消化道内摄入异物接受内镜取出术的次数在2次至38次之间。因此,在3年期间,通过143次内镜检查取出了265个异物。最常见的是不同长度的汤匙柄和瓷器碎片。异物几乎总是能成功取出且无并发症。只有一把牢固嵌顿在胃底和胃窦之间的刀需要进行外科胃切开术。根据异物的类型、大小和数量、内镜手术预期的复杂性以及报告的禁食期,约40%的内镜检查在气管插管气道保护下进行。尽管有相当大的个人和物质费用,但大多数胃肠病学家、精神科医生和外科医生主张即使考虑到反复摄入异物的情况,也应重复进行异物取出术。