Shrestha Nischal, Regmee Sujan, Kharel Abhiyan, Guragai Mandeep
Department of Surgery, Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.
Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.
Ann Med Surg (Lond). 2022 Sep 5;82:104564. doi: 10.1016/j.amsu.2022.104564. eCollection 2022 Oct.
Foreign body bezoar is a relatively uncommon variant of bezoars leading to intestinal obstruction and perforation. These are caused by the ingestion of indigestible materials that gradually grow in size.
Following is the case of a young female patient with abdominal pain and distension which was associated with nausea, vomiting, and obstipation. Contrast-enhanced computed tomography of the abdomen showed dilated jejunal and ileal loops, and a tubular hypodense structure on terminal ileum. During surgery, we discovered intraluminal foreign bodies and ileal perforation proximal to the ileocecal valve. The findings were suggestive of obstruction and perforation of terminal ileum secondary to foreign body obstruction. The patient was managed successfully with ileocolic resection and anastomosis.
Patients with bezoars can remain asymptomatic or present with features of bowel obstruction. These are usually discovered while performing radiological imaging for the evaluation of symptoms. Though mild to moderate cases of bezoars resolve with the treatment by chemical dissolution, surgeries should be performed in patients with foreign body bezoars and in whom complications have arose.
Ingested foreign body could lead to formation of a bezoar which may cause obstruction and perforation-the sequelae must be kept in mind while managing a patient.
异物性胃石是胃石中相对少见的一种类型，可导致肠梗阻和肠穿孔。它们是由摄入不可消化的物质引起的，这些物质会逐渐增大。
以下是一名年轻女性患者的病例，该患者有腹痛和腹胀症状，并伴有恶心、呕吐和便秘。腹部增强计算机断层扫描显示空肠和回肠肠袢扩张，回肠末端有一个管状低密度结构。手术过程中，我们发现肠腔内有异物，回盲瓣近端回肠穿孔。这些发现提示异物梗阻继发回肠末端梗阻和穿孔。患者通过回结肠切除吻合术成功治愈。
胃石患者可能无症状，或表现出肠梗阻的特征。这些通常是在对症状进行评估而进行放射学成像检查时发现的。虽然轻度至中度胃石病例可通过化学溶解治疗得到缓解，但对于异物性胃石且已出现并发症的患者，应进行手术治疗。
摄入异物可导致胃石形成，进而可能引起梗阻和穿孔——在治疗患者时必须牢记这些后遗症。
