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腹腔镜下取出牙刷致十二指肠异物意外一例:病例报告

Accidental duodenal foreign body of toothbrush removed laparoscopically: a case report.

作者信息

Soga Masahiro, Tanaka Tetsuya, Ueda Takeshi, Kirihataya Yuki, Yamaguchi Yohei, Okura Yasushi, Sawai Masayoshi, Yoshimura Atsushi

机构信息

Department of Surgery, Minami-Nara General Medical Center, 8-1 Oaza-Fukugami Oyodo-cho Yoshino-gun, Nara, 638-8551, Japan.

Department of Gastroenterology, Minami-Nara General Medical Center, 8-1 Oaza-Fukugami Oyodo-cho Yoshino-gun, Nara, 638-8551, Japan.

出版信息

Surg Case Rep. 2022 Jul 27;8(1):141. doi: 10.1186/s40792-022-01501-x.

Abstract

BACKGROUND

Foreign body ingestion is a common case in daily medical care, and it usually passes through the entire gastrointestinal tract naturally and is excreted in the feces. However, long and sharp foreign bodies may be difficult to pass naturally due to their shape. Here, we present a rare case of a duodenal foreign body, a toothbrush, that required laparoscopic surgical removal after a failed endoscopic attempt.

CASE PRESENTATION

A 51-year-old male with intellectual disability presented to our hospital due to fever. Initially, he was diagnosed with aspiration pneumonia by chest X-ray and blood examination. However, abdominal X-ray examination suggested a foreign body, and a computed tomography scan revealed a toothbrush in the duodenum. Therefore, upper gastrointestinal endoscopy was immediately attempted to remove it, but it could not be safely removed because the handle part of the toothbrush seemed deeply embedded in the duodenal mucosa. Therefore, this case was diagnosed as duodenal incarceration of the toothbrush, and it was removed by laparoscopic surgery. The operation was performed safely, and the patient's postoperative course was good without any complications. The extracted toothbrush was 15 cm in length.

CONCLUSION

We experienced a rare case of a duodenal foreign body, which was a toothbrush. The duodenal foreign body was safely removed by laparoscopic surgery for the first time.

摘要

背景

异物摄入是日常医疗中常见的病例,通常会自然通过整个胃肠道并随粪便排出。然而,又长又尖的异物因其形状可能难以自然通过。在此,我们报告一例罕见的十二指肠异物病例,该异物为一把牙刷,在内镜尝试取出失败后,需通过腹腔镜手术取出。

病例介绍

一名51岁的智障男性因发热前来我院就诊。最初,通过胸部X光和血液检查诊断为吸入性肺炎。然而,腹部X光检查提示有异物,计算机断层扫描显示十二指肠内有一把牙刷。因此,立即尝试通过上消化道内镜取出异物,但由于牙刷的手柄部分似乎深深嵌入十二指肠黏膜,无法安全取出。因此,该病例被诊断为牙刷十二指肠嵌顿,并通过腹腔镜手术取出。手术顺利进行,患者术后恢复良好,无任何并发症。取出的牙刷长15厘米。

结论

我们遇到了一例罕见的十二指肠异物病例,异物为一把牙刷。首次通过腹腔镜手术安全取出十二指肠异物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0eba/9329496/107da024e350/40792_2022_1501_Fig1_HTML.jpg

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