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腹腔镜取出小儿直肠异物无症状穿孔至腹腔的处理:1例报告并文献复习

Management of Asymptomatic Perforation of a Pediatric Rectal Foreign Body into the Peritoneal Cavity Retrieved with Laparoscopy: A Case Report and Review of the Literature.

作者信息

Forooghi Mehdi, Kamran Hooman, Shahriarirad Reza

机构信息

Department of Pediatric Surgery, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Case Rep Med. 2021 Nov 28;2021:5851967. doi: 10.1155/2021/5851967. eCollection 2021.

Abstract

Rectal foreign body insertion has had an increasing trend throughout the years, whereas it is rarely reported in pediatrics. The management and treatment of these cases can become challenging, since it also can present with atypical or even no symptoms in physical evaluation. A 14-year-old boy was referred to our hospital with a history of insertion of a paintbrush into his anus four weeks before the admission. The paintbrush had perforated the colon and was in the abdominopelvic cavity; however, no symptoms of peritonitis were observed. Rectal examination, sigmoidoscopy, and colonoscopy were unremarkable. Exploratory laparoscopy was performed, and the paintbrush was taken out completely. The patient was discharged in good condition. In cases with rectal foreign body insertion, perforation without causing peritonitis or acute abdomen is possible. In these conditions, imaging examinations play an essential role in managing the patients, and laparoscopy can be a proper procedure for retrieving the foreign body.

摘要

多年来,直肠异物插入呈上升趋势,而儿科病例鲜有报道。这些病例的管理和治疗颇具挑战性,因为在体格检查中也可能表现为非典型症状甚至无症状。一名14岁男孩因在入院前四周将画笔插入肛门的病史被转诊至我院。画笔已穿透结肠并进入腹腔盆腔;然而,未观察到腹膜炎症状。直肠指检、乙状结肠镜检查和结肠镜检查均无异常。进行了 exploratory laparoscopy,画笔被完全取出。患者康复出院。在直肠异物插入的病例中,有可能发生穿孔但不引起腹膜炎或急腹症。在这些情况下,影像学检查在患者管理中起着至关重要的作用,laparoscopy 可能是取出异物的合适方法。

文中“exploratory laparoscopy”和“laparoscopy”未找到准确对应的中文医学术语,保留英文。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5972/8645393/0e91b847444b/CRIM2021-5851967.001.jpg

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