Bajaber Abubakr, Shariff Safa, Azhar Muhammad, Ayashi Mariam, Moawed Mohammed, Bajaber Omar
College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.
College of Medicine, Al-Rayan Colleges, Madinah 42541, Saudi Arabia.
Radiol Case Rep. 2024 Aug 10;19(11):4741-4746. doi: 10.1016/j.radcr.2024.07.071. eCollection 2024 Nov.
Children are frequently reported as cases of foreign body ingestion, with fishbone ingestion being particularly prevalent in communities where fish consumption is common. Although many instances of foreign body ingestion resolve spontaneously, the ingestion of sharp objects like fishbones poses a greater risk of morbidity and mortality due to their propensity for causing complications. Furthermore, incidents of foreign body ingestion often present with nonspecific symptoms or may go unnoticed, potentially leading to misdiagnosis and complicating the clinical course. We present a case of a 2-year-old boy initially misdiagnosed with constipation and treated with laxatives due to intermittent progressive abdominal pain. Subsequently, he presented to the emergency department where radiological and laboratory investigations revealed signs of inflammation and localized abdominal fluid collection containing a linear hyperdense object, indicating complicated foreign body ingestion with perforation. Urgent laparotomy revealed an omental abscess, which was excised, and the perforation site was repaired with sutures. This case underscores the risk of misdiagnosis and the importance of timely recognition and management. It also emphasizes the critical role of imaging, particularly computed tomography, in accurate diagnosis and differentiation from other common conditions.
儿童经常被报道为异物摄入病例,在鱼类消费普遍的社区中,鱼骨摄入尤为常见。尽管许多异物摄入情况会自行缓解,但由于鱼骨等尖锐物体容易引发并发症,因此其摄入导致发病和死亡的风险更高。此外,异物摄入事件通常表现为非特异性症状,或者可能未被注意到,这可能导致误诊并使临床病程复杂化。我们报告一例2岁男孩的病例,该男孩最初因间歇性进行性腹痛被误诊为便秘,并接受了泻药治疗。随后,他被送往急诊科,影像学和实验室检查显示有炎症迹象以及局部腹腔积液,积液中含有一个线性高密度物体,提示异物摄入并伴有穿孔的复杂情况。紧急剖腹探查发现一个网膜脓肿,将其切除,并对穿孔部位进行了缝合修复。该病例强调了误诊的风险以及及时识别和处理的重要性。它还强调了影像学检查(尤其是计算机断层扫描)在准确诊断以及与其他常见病症鉴别方面的关键作用。