Tola Gutu Ganati, Tesso Birhanu Abdisa, Moges Tadesse Girma, Abebe Dabessa Mosissa
Department of Surgery, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia.
Department of Surgery, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia.
Int J Surg Case Rep. 2024 Jul;120:109794. doi: 10.1016/j.ijscr.2024.109794. Epub 2024 May 22.
Ingested foreign bodies fail to pass spontaneously through the gastrointestinal tract in about 20 % of the cases and result in complications in about 1 % of the cases. One of the complications is the migration of the foreign body to the adjacent structure.
A 25-year-old female lady presented to our hospital with a 15-cm-long coilable and insulated electrical wire foreign body in her abdomen, which extended from the descending colon to the right upper quadrant abdominal wall. Intra-abdominally, the object was located in the general peritoneum without penetrating the bowel or vascular structure. It was complicated by an abdominal wall abscess without any collection in the general peritoneum. The foreign body was then successfully retracted from the abdomen through a right upper quadrant incision without any complications thereafter.
The uncomplicated passage of foreign bodies through the gastrointestinal tract largely depends on the types of objects. Sharp, elongated objects are more likely to be arrested in the bowel commonly at the point of acute angulation and narrowing. The stacked foreign body may then result in different complications, including penetration and migration of the object. Migration of an insulated electrical wire to the anterior abdominal wall, which we encountered, is extremely rare and can pose a difficulty and dilemma in deciding on management options.
For an externally accessible, migrated intra-abdominal foreign body that does not result in peritonitis and is confirmed to be located out of the bowel, an exploratory laparotomy could be avoided.
约20%的摄入异物无法自行通过胃肠道，约1%的病例会引发并发症。其中一种并发症是异物迁移至邻近结构。
一名25岁女性因腹部有一根15厘米长的可卷曲绝缘电线异物就诊于我院，该异物从降结肠延伸至右上腹腹壁。在腹腔内，异物位于腹膜腔，未穿透肠道或血管结构。其并发症为腹壁脓肿，腹膜腔内无积液。随后通过右上腹切口成功将异物从腹部取出，此后未出现任何并发症。
异物在胃肠道内顺利通过很大程度上取决于异物类型。尖锐、细长的异物更易卡在肠道内，通常在急性成角和变窄处。堆叠的异物可能会导致不同并发症，包括异物穿透和迁移。我们遇到的绝缘电线迁移至前腹壁的情况极为罕见，在决定治疗方案时可能会带来困难和困境。
对于可从外部触及、已迁移至腹腔且未导致腹膜炎且确认位于肠道外的异物，可避免进行剖腹探查术。
