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肛管内误食鸡骨(剑突):一例病例报告及文献综述

Ingested Chicken Bone (Xiphoid Process) in the Anal Canal: A Case Report and Literature Review.

作者信息

Alkandari Ahmed F, Alsarraf Husain M, Alkandari Mohammed F

机构信息

Department of Anatomy, Kuwait University, Jabriya, KWT.

Department of Surgery, Al-Adan Hospital, Al-Ahmadi, KWT.

出版信息

Cureus. 2023 Feb 16;15(2):e35060. doi: 10.7759/cureus.35060. eCollection 2023 Feb.

Abstract

Accidental foreign body (FB) ingestion is common in the elderly, particularly edentulous and denture wearers. The most commonly ingested FBs are food-related, including fish and chicken bones. While small FBs can pass through the gastrointestinal tract without any complications, large or irregular-shaped FBs usually cause complications. These complications include choking, ulceration, perforation, fistula, abscess formation, or even death. Ingestion of a large chicken bone that reaches the anal canal without causing injury is extremely rare. We present a rare case of accidental chicken bone (xiphoid process) ingestion that manifested itself by projecting from the anus while defecating. Interestingly, the patient did not experience any food choking or abdominal pain, nor did she have any type of dementia. However, the patient could not grind food properly due to the loss of her upper molar teeth, which made her develop a habit of rapid swallowing. On examination, the chicken bone was seen within the anus with a sharp edge embedded in the mucosal wall. While a plain pelvic X-ray failed to display the FB, a pelvic CT scan with a 3D illustration showed its dimensions (5.0 x 2.5 x 3 cm). A plain pelvic CT scan confirmed the presence of the bone-contrast FB within the anal canal without injuring the surrounding anatomical structures. The FB was gently manipulated and successfully extracted after administering 5 ml of lidocaine gel enema. The patient was counseled regarding proper chewing habits, and she was referred to a dental clinic for a professional assessment. Seven days later, the patient was seen again at the clinic for a follow-up and was found to have an uneventful recovery. Maintaining good dental health and proper eating habits, as well as increasing awareness among edentulous individuals and denture wearers, are required to prevent accidental FB ingestions.

摘要

意外吞食异物(FB)在老年人中很常见,尤其是无牙和佩戴假牙的人。最常吞食的异物与食物有关,包括鱼骨和鸡骨。虽然小的异物可以通过胃肠道而不引起任何并发症,但大的或形状不规则的异物通常会导致并发症。这些并发症包括窒息、溃疡、穿孔、瘘管、脓肿形成,甚至死亡。吞食一根大鸡骨却能到达肛管而不造成损伤极为罕见。我们报告一例罕见的意外吞食鸡骨(剑突)病例,该鸡骨在排便时从肛门突出。有趣的是,患者没有经历任何食物窒息或腹痛,也没有任何类型的痴呆。然而,由于上颌磨牙缺失,患者无法正常咀嚼食物,这使她养成了快速吞咽的习惯。检查时,在肛门内可见鸡骨,其尖锐边缘嵌入粘膜壁。虽然盆腔平片未能显示异物,但盆腔CT扫描及三维成像显示了其尺寸(5.0×2.5×3厘米)。盆腔平扫CT证实肛管内存在骨造影剂显影的异物,且未损伤周围解剖结构。在给予5毫升利多卡因凝胶灌肠后,轻柔操作并成功取出异物。我们对患者进行了正确咀嚼习惯的指导,并将她转诊至牙科诊所进行专业评估。七天后,患者再次到诊所复诊,恢复情况良好。为预防意外吞食异物,需要保持良好的口腔健康和正确的饮食习惯,并提高无牙者和假牙佩戴者的意识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d99/10024513/1036b10cb11c/cureus-0015-00000035060-i01.jpg

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