Wang Qiang, Cheng Shujie, Zhang Xuejiao, Xie Tianhao, Sun Xinli, Niu Zheng, Liu Yahan, Jin Xiaoshi
Department of General Surgery Affiliated Hospital of Hebei University Baoding Hebei Province China.
Hebei Institute of Dermatology Baoding Hebei Province China.
Clin Case Rep. 2024 Jan 28;12(2):e8142. doi: 10.1002/ccr3.8142. eCollection 2024 Feb.
Ingestion of foreign bodies is very common in clinical practice. However, gastrointestinal perforation caused by a foreign body is rare, as most foreign bodies can pass the alimentary tract spontaneously or be removed endoscopically. Ingesting a foreign body causes gastrointestinal tract perforation in less than 1% of cases that require surgery. In the past, the literature about gastrointestinal tract perforation caused by foreign bodies had been widely reported worldwide. However, the case of foreign bodies causing gastrointestinal perforation without significant abdominal infection was rarely documented. A 47-year-old woman presented with intermittent left lower abdominal pain associated with a mass for 1 month and had no other symptoms. Laparotomy was performed after clinical assessment. During the operation, a local inflammatory mass that adhered to the abdominal wall, part of the small intestine, and sigmoid colon was found in the left lower quarter of the abdominal cavity. The surrounding intestinal wall was edematous. There were two bony foreign bodies in it. Postoperative pathology suggested an inflammatory mass. A foreign body rarely migrates into the abdominal cavity without symptoms that may be related to the omentum's slow perforation process and good function. The best treatment is surgery and using appropriate antibiotics.
在临床实践中,吞食异物非常常见。然而,异物导致的胃肠道穿孔却很罕见,因为大多数异物能够自行通过消化道或通过内镜取出。在需要手术的病例中,吞食异物导致胃肠道穿孔的情况不到1%。过去,关于异物导致胃肠道穿孔的文献在全球范围内已有广泛报道。然而,异物导致胃肠道穿孔且无明显腹部感染的病例却鲜有记载。一名47岁女性因间歇性左下腹疼痛伴肿块1个月就诊,无其他症状。经临床评估后进行了剖腹手术。术中发现腹腔左下腹有一个局部炎性肿块,与腹壁、部分小肠和乙状结肠粘连。周围肠壁水肿。肿块内有两个骨质异物。术后病理提示为炎性肿块。异物很少在没有症状的情况下迁移至腹腔,这可能与大网膜缓慢的穿孔过程及其良好的功能有关。最佳治疗方法是手术并使用适当的抗生素。