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意外吞食鸡骨继发回肠穿孔性腹膜炎:一例报告

Ileal perforation peritonitis secondary to accidental ingestion of a chicken bone: A case report.

作者信息

Panday Bijay, Bhatta Om Prakash, Gyawali Prakash, Dangol Rojan Singh, Joshi Mandeep Dutta, Neupane Bhoj Raj

机构信息

Department of General Surgery, Gandaki Medical College and Teaching Hospital, Pokhara, Nepal.

Department of Emergency Medicine, Nova Hospital, Dhangadhi, Nepal.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110284. doi: 10.1016/j.ijscr.2024.110284. Epub 2024 Sep 12.

Abstract

INTRODUCTION AND IMPORTANCE

Ileal perforation is a rare but serious condition that can arise from accidental ingestion of foreign objects. This report discusses an unusual case of ileal perforation peritonitis caused by ingestion of a chicken bone.

CASE PRESENTATION

A 60-year-old male presented with acute generalized abdominal pain, fever, nausea, and vomiting for three days. A physical examination revealed signs of peritonitis. Imaging results were unremarkable. Emergency laparotomy revealed perforation in the ileum caused by the chicken bone. The perforated segment was resected, and primary anastomosis was performed.

CLINICAL DISCUSSION

Ingestion of foreign bodies, although common, rarely leads to gastrointestinal perforations. Among these foreign bodies, chicken bones are rarely reported, making the diagnosis challenging because of nonspecific symptoms and low clinical suspicion. Prompt surgical intervention is crucial for managing complications such as peritonitis and sepsis.

CONCLUSION

This case highlights the importance of considering foreign body ingestion in the differential diagnosis of acute abdominal pain, particularly in patients without an obvious cause of peritonitis. Early detection and timely surgical intervention are essential to improve patient outcomes.

摘要

引言与重要性

回肠穿孔是一种罕见但严重的病症,可能由意外吞食异物引起。本报告讨论了一例因吞食鸡骨导致的回肠穿孔性腹膜炎的罕见病例。

病例介绍

一名60岁男性出现急性全腹痛、发热、恶心和呕吐症状三天。体格检查发现腹膜炎体征。影像学检查结果无异常。急诊剖腹探查发现鸡骨导致回肠穿孔。切除穿孔段并进行了一期吻合术。

临床讨论

吞食异物虽常见,但很少导致胃肠道穿孔。在这些异物中,鸡骨的报道很少,由于症状不具特异性且临床怀疑度低,诊断具有挑战性。及时的手术干预对于处理腹膜炎和败血症等并发症至关重要。

结论

本病例凸显了在急性腹痛的鉴别诊断中考虑异物吞食的重要性,尤其是在没有明显腹膜炎病因的患者中。早期发现和及时的手术干预对于改善患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4aac/11421265/764dd15c20cd/gr1.jpg

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