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胃镜与纤维支气管镜联合应用有助于取出嵌顿于食管的鱼骨:1例病例报告

Combination of gastroscopy and fibro‑bronchoscopy facilitates removal of incarcerated fish bone in the esophagus: A case report.

作者信息

Ma Yihan, Tian Yong, Chen Yao, Ran Hongmei, Pan Tao, Xiong Xing

机构信息

Department of Gastroenterology, Chengdu First People's Hospital, Chengdu, Sichuan 610041, P.R. China.

Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610037, P.R. China.

出版信息

Exp Ther Med. 2023 Sep 21;26(5):518. doi: 10.3892/etm.2023.12217. eCollection 2023 Nov.

Abstract

Esophageal foreign body impaction is a notable clinical emergency. If the high-risk esophageal foreign bodies are not removed in time, life-threatening complications, such as perforation, infection and injury to the vessels, may occur. In the present study, the case of a patient experiencing a foreign body sensation in the throat after ingesting a fish bone by mistake is presented. A high risk of impending arterial puncture was confirmed using thoracic CT and thoracic aorta CT angiography scanning. The ends of the fish bone were first confirmed using a fibro-bronchoscopy light source passing through the bronchial and esophageal walls, before biopsy forceps were used to successively free the thoracic aorta and bronchial ends under gastroscopy. Finally, the fish bone was safely removed using a combination of gastroscopy and the rarely used fibro-bronchoscopy, and the patient recovered well after standard care. In certain cases of foreign bodies, it is necessary to use multiple strategies in a timely manner according to the type and location of the ingested foreign body.

摘要

食管异物嵌顿是一种显著的临床急症。如果高危食管异物不及时取出,可能会发生危及生命的并发症,如穿孔、感染和血管损伤。在本研究中,报告了一例患者误吞鱼骨后出现咽部异物感的病例。通过胸部CT和胸主动脉CT血管造影扫描确认存在即将发生动脉穿刺的高风险。在用活检钳在胃镜下依次松解胸主动脉和支气管端之前,首先使用穿过支气管壁和食管壁的纤维支气管镜光源确认鱼骨的两端。最后,联合使用胃镜和很少使用的纤维支气管镜安全地取出了鱼骨,患者在标准护理后恢复良好。在某些异物病例中,有必要根据摄入异物的类型和位置及时采用多种策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92c9/10580255/ad76f83cf454/etm-26-05-12217-g00.jpg

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