Boumarah Dhuha N, Binkhamis Lujain S, AlDuhileb Mohammed
Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, College of Medicine, Dammam, Saudi Arabia.
Department of Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Ann Med Surg (Lond). 2022 Nov 14;84:104944. doi: 10.1016/j.amsu.2022.104944. eCollection 2022 Dec.
Intentional and accidental foreign body ingestion are commonly encountered in clinical practice. In adults, intentional foreign body ingestion is frequently observed among individuals with psychiatric disorders and prisoners. Controversies exist regarding the management of sharp or pointed objects. We contribute to this existing controversy by presenting a case of a 43-year-old male who accidently ingested a metallic screw and was managed successfully through endoscopic retrieval.
We discuss a case of a 43-year-old male presented to our emergency department after accidently swallowing a metallic screw, 1 h and a half prior to his presentation. He was initially asymptomatic then started to complain of vague abdominal symptoms. X-rays of the chest and abdomen demonstrated the presence of a metallic screw at the mid-abdomen. Computed tomography scan of the abdomen then confirmed its presence within the gastric lumen, with no evidence of gastric or bowel perforation. The patient was managed via esophagogastroduodenoscopy in which the ingested screw was extracted. He was discharged after 24 hours in a good condition.
A limited number of epidemiological studies have shed light on the prevalence and incidence of foreign body ingestion among adult individuals. Probability of spontaneous passage depends on several factors including the size, shape and composition of the impacted item, as well as the age of patient and duration of ingestion prior to presentation.
Considering the variation of ingested objects and the availability of several therapeutic approaches, a patient-tailored management plan should always be established.
在临床实践中，有意和意外吞食异物的情况很常见。在成年人中，有意吞食异物常见于患有精神疾病的个体和囚犯。对于尖锐或带尖物体的处理存在争议。我们通过呈现一例43岁男性意外吞食金属螺丝并通过内镜取出成功处理的病例，为这一现存争议提供了补充。
我们讨论一例43岁男性病例，该患者在意外吞食金属螺丝后1个半小时就诊于我们的急诊科。他最初无症状，随后开始抱怨腹部有模糊不清的症状。胸部和腹部X线显示中腹部有一枚金属螺丝。腹部计算机断层扫描随后证实其位于胃腔内，且没有胃或肠穿孔的迹象。患者通过食管胃十二指肠镜进行处理，取出了吞食的螺丝。他在24小时后状况良好出院。
有限的流行病学研究揭示了成年个体中异物吞食的患病率和发病率。自然排出的可能性取决于几个因素，包括受困物体的大小、形状和成分，以及患者年龄和就诊前吞食的持续时间。
考虑到吞食物体的多样性和多种治疗方法的可用性，应始终制定针对患者的管理计划。
