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棉籽瘤导致的上消化道梗阻:一例罕见的外科病例报告。

Upper gastrointestinal tract obstruction caused by a gossypiboma: A rare surgical case report.

作者信息

Danial Aghyad Kurda, Al-Jawad Mohammad, Naima Munzer, Lbabidi Nour Abdulazize, Nabhan Mohammad Hassan, Alhaj Ahmad

机构信息

University of Aleppo, Faculty of Medicine, Aleppo, Syria.

University of Aleppo, Faculty of Medicine, Aleppo, Syria.

出版信息

Int J Surg Case Rep. 2023 Dec;113:109067. doi: 10.1016/j.ijscr.2023.109067. Epub 2023 Nov 17.

DOI:10.1016/j.ijscr.2023.109067
PMID:37992669
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10667764/
Abstract

INTRODUCTION

Gossypiboma is a term used to describe a condition of leaving a surgical sponge or any other foreign object in a body cavity after surgery. Gossypiboma is a rare but serious medical and legal problem, as it may cause no symptoms or severe complications in the digestive system. In some cases, Gossypiboma may migrate through the wall of an organ and cause damage, such as perforation, obstruction, or fistula formation.

CASE REPORT

A 46-year-old male presented to the Emergency Department with abdominal pain, diarrhea, vomiting, and weight loss of about 15 kg through 20 days. The condition developed into constipation.

DISCUSSION

The prevalence of complications, known as Gossypibomas, is relatively rare but can cause inflammatory reactions, abscesses, and other complications. Diagnosis is challenging and may require thorough evaluation, imaging, and exploratory surgery. Treatment usually involves surgical removal, either through laparoscopy or laparotomy. Prevention methods, such as accurate counting and implementing surgical safety protocols, are crucial to avoid such incidents.

CONCLUSION

Performing a thorough count of all surgical sponges and instruments at both the start and conclusion of the procedure is the most effective method to prevent Gossypiboma. Other preventive measures include using radiopaque sponges and making sure that all sponges are accounted for before closing the incision.

摘要

引言

棉籽瘤是一个用于描述手术后将手术海绵或任何其他异物留在体腔内的病症的术语。棉籽瘤是一种罕见但严重的医学和法律问题,因为它可能在消化系统中不引起任何症状或导致严重并发症。在某些情况下,棉籽瘤可能会穿过器官壁并造成损害,如穿孔、梗阻或瘘管形成。

病例报告

一名46岁男性因腹痛、腹泻、呕吐以及在20天内体重减轻约15公斤就诊于急诊科。病情发展为便秘。

讨论

被称为棉籽瘤的并发症的发生率相对较低,但可能会引起炎症反应、脓肿及其他并发症。诊断具有挑战性,可能需要进行全面评估、影像学检查和探查性手术。治疗通常包括通过腹腔镜手术或剖腹手术进行手术切除。诸如准确计数和实施手术安全规程等预防方法对于避免此类事件至关重要。

结论

在手术开始和结束时对所有手术海绵和器械进行全面计数是预防棉籽瘤的最有效方法。其他预防措施包括使用不透射线的海绵,并确保在关闭切口前所有海绵都已清点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/53ac0a4c9397/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/95929ba86e89/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/f612aac3ffa7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/e8081bc3cbe6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/9a68003ad715/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/53ac0a4c9397/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/95929ba86e89/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/f612aac3ffa7/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/e8081bc3cbe6/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/9a68003ad715/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/224d/10667764/53ac0a4c9397/gr5.jpg

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