Hatgaonkar Anand, Hatgaonkar Kajal, Bankar Nandkishor J
Professor and Head, Department of Radiology, Datta Meghe Medical College Nagpur, Datta Meghe Institute of Higher Education and Research (DU), Sawangi (Meghe), Wardha, India.
Assistant Professor, Department of Pathology, Datta Meghe Medical College Nagpur, Datta Meghe Institute of Higher Education and Research (DU), Sawangi (Meghe), Wardha, India.
Radiol Case Rep. 2023 Sep 2;18(11):4042-4047. doi: 10.1016/j.radcr.2023.08.011. eCollection 2023 Nov.
Foreign bodies are uncommon, and the migration of ingested or inserted foreign bodies within or out of the gastrointestinal tract is even rarer. Migration of foreign objects from the digestive system to the soft tissue in the neck, genitourinary tract, or abdominal cavity to intraluminal extension in bowel loops is an uncommon but well-reported occurrence. The accidentally retained surgical sponge (gossypiboma) following abdominal or pelvic surgery with transmural migration within the bowel is an extremely rare clinical presentation. The bowel can be penetrated by retained material, which moves within the bowel lumen, resulting in malabsorption, intestinal obstruction, either partial or complete. In a few cases, spontaneous expulsion occurs. The interpretation is done on radiographs in frontal and lateral projections X-rays, magnetic resonance imaging (MRI), computed tomography (CT), and ultrasonography (USG). Computed tomography (CT) is helpful if a radiopaque foreign body is suspected and is the modality of choice. We share with you 2 instances of foreign items migrating outside the digestive tract with a possible history of ingestion and a case of transmural migration of the postcesarean section retained surgical sponge within the alimentary tract, causing bowel obstruction. Diagnosis and the exact location of a foreign body can be established with the judicious use of different modalities. A CT scan is the modality of choice because it provides a road map for surgical intervention.
异物并不常见，而摄入或插入的异物在胃肠道内或胃肠道外迁移的情况则更为罕见。异物从消化系统迁移至颈部、泌尿生殖道或腹腔的软组织，再至肠袢内的管腔延伸，这种情况虽不常见，但已有充分报道。腹部或盆腔手术后意外残留的手术海绵（棉籽瘤）经肠壁迁移至肠内，是一种极为罕见的临床表现。残留物质可穿透肠壁，在肠腔内移动，导致吸收不良、部分或完全性肠梗阻。在少数情况下，异物会自发排出。通过X线正侧位片、磁共振成像（MRI）、计算机断层扫描（CT）和超声检查（USG）进行诊断。如果怀疑存在不透X线的异物，计算机断层扫描（CT）会很有帮助，是首选检查方式。我们与您分享2例有摄入史的异物迁移至消化道外的病例，以及1例剖宫产术后残留手术海绵在消化道内经肠壁迁移导致肠梗阻的病例。合理运用不同检查方式可明确异物的诊断及确切位置。CT扫描是首选方式，因为它可为手术干预提供路线图。
