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牙髓凝固致回肠穿孔——微创手术治疗

Ileal perforation by a solidified root pulp - Minimally invasive surgery management.

作者信息

Galhotra Anmol, Veetil Deepa Kizhakke, Wadhawan Randeep, Bhardwaj Arun, Verma Naveen

机构信息

Department of Minimal Access Surgery, Gastrointestinal and Bariatric Surgery, Manipal Hospitals, Dwarka, Delhi, India.

Department of Minimal Access Surgery, Manipal Hospital, Dwarka, Delhi, India.

出版信息

J Minim Access Surg. 2025 Jan 1;21(1):86-88. doi: 10.4103/jmas.jmas_312_23. Epub 2024 Oct 9.

Abstract

Foreign body (FB) ingestion results in perforation in 1% of cases and is associated with significant morbidity and rarely mortality. This case reports the delayed presentation of distal ileal perforation following accidental ingestion of solidified root pulp. A 46-year-old male presented to the emergency department with complaints of right iliac fossa pain, clinical diagnosis of appendicitis was made. Computed tomography of the abdomen revealed an FB in the distal ileum with contained perforation. Revised history was suggestive of FB aspiration during root canal therapy 3 weeks back. The patient underwent diagnostic laparoscopy, removal of FB and primary closure of the perforation. FB was revealed to be solidified root pulp macroscopically and hyalinised material microscopically. Localised perforation following ingestion of FB results in significant morbidity due to delayed diagnosis. With the increasing number of dental procedures, this becomes relevant globally as well. Varied clinical presentations pose diagnostic challenges to the clinician.

摘要

异物(FB)摄入导致穿孔的病例占1%,并伴有显著的发病率,死亡率罕见。本病例报告了意外摄入凝固牙髓后出现的回肠末端穿孔延迟表现。一名46岁男性因右下腹疼痛就诊于急诊科,临床诊断为阑尾炎。腹部计算机断层扫描显示回肠末端有一异物并伴有穿孔。修正后的病史提示3周前根管治疗期间误吸了异物。患者接受了诊断性腹腔镜检查,取出异物并对穿孔进行了一期缝合。肉眼可见异物为凝固牙髓,显微镜下为透明变性物质。异物摄入后局部穿孔因诊断延迟导致显著的发病率。随着牙科手术数量的增加,这在全球范围内也变得很重要。多样的临床表现给临床医生带来了诊断挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e1d/11838793/ec6212ccbc8a/JMAS-21-86-g001.jpg

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