Mohanty Debajyoti, Dugar Dharmendra, Waliya Asish
General Surgery, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Cureus. 2023 Aug 24;15(8):e44068. doi: 10.7759/cureus.44068. eCollection 2023 Aug.
We present a 45-year-old man with small bowel perforation resulting from the inadvertent ingestion of a right-angled thorn of the Gum Arabic plant (Vachellia nilotica). The diagnosis was made, and an emergency laparotomy was performed for suspected enteric peritonitis. The thorn was found projecting from the terminal ileum with a minimal intra-peritoneal fluid collection. The thorn was removed, and the perforation site was repaired primarily with absorbable sutures. The lack of a reliable history of foreign body ingestion makes it impossible to arrive at an accurate preoperative diagnosis in patients presenting with perforation peritonitis. Radiological investigations have a low sensitivity for detecting radiolucent vegetative foreign bodies as the cause of bowel perforations. Primary repair should be preferred over resection procedures in the management of foreign body-induced small bowel perforations.
我们报告一名45岁男性，因误食阿拉伯胶树（阿拉伯相思树）的直角刺导致小肠穿孔。做出诊断后，因怀疑有肠源性腹膜炎而进行了急诊剖腹手术。发现刺从回肠末端穿出，腹腔内仅有少量积液。取出刺后，穿孔部位先用可吸收缝线进行了一期修复。对于出现穿孔性腹膜炎的患者，由于缺乏可靠的异物摄入史，术前无法做出准确诊断。放射学检查对检测作为肠穿孔原因的透光性植物性异物的敏感性较低。在处理异物所致小肠穿孔时，一期修复应优于切除手术。
