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在尝试通过食管镜取出嵌顿假牙失败后成功进行食管切开术。

Successful esophagotomy after failed attempts of esophagoscopic retrieval of impacted denture.

作者信息

Fatima Saba, Ullah Muhammad Salman, Khalid Bushra, Khalid Muhammad Omer, Ahmad Rana Uzair

机构信息

Mayo hospital, Anarkali, Lahore, Punjab 54000, Pakistan.

出版信息

Radiol Case Rep. 2024 Nov 22;20(2):878-881. doi: 10.1016/j.radcr.2024.09.085. eCollection 2025 Feb.

Abstract

Ingested foreign bodies, although fairly common among children, can present in individuals of all age. Most common risk factors for such cases in adults include psychiatric illness, alcohol abuse and ill-fitting dentures. Most of the ingested foreign bodies pass through the gastrointestinal tract but intervention maybe required in case of impaction, obstruction or perforation. Foreign bodies mostly tend to get impacted at anatomical constrictions like cricopharyngeus, aortic arch and lower esophageal sphincter. We present a rare case of impacted denture in esophagus which could not be retrieved despite multiple esophagoscopic retrieval attempts leading to removal by successful esophagotomy. Investigations including X-ray and rigid esophagoscopy confirmed the presence of denture with its hooks impacted in the esophageal wall at the level of C6-C7 vertebra. Majority of the foreign bodies can be removed by flexible endoscopy or esophagoscopy but due to its impaction in esophageal wall these techniques were unsuccessful. Therefore, multidisciplinary team decided to opt for an esophagotomy with transcervical approach. Successful esophagotomy was performed with the retrieval of sharp hook like body. Our case underscores the importance of early surgical intervention in case of failed attempt to remove the foreign body through minimally invasive techniques to prevent complications in form of perforation and mediastinitis.

摘要

摄入异物在儿童中较为常见,但各年龄段人群均可发生。成人发生此类情况的最常见危险因素包括精神疾病、酗酒和假牙不合适。大多数摄入的异物会通过胃肠道排出,但在发生嵌顿、梗阻或穿孔时可能需要进行干预。异物大多倾向于嵌顿在诸如环咽肌、主动脉弓和食管下括约肌等解剖狭窄处。我们报告一例罕见的食管内假牙嵌顿病例,尽管多次尝试通过食管镜取出均未成功,最终通过成功的食管切开术才得以取出。包括X线和硬质食管镜检查在内的检查证实假牙存在,其挂钩嵌顿在C6 - C7椎体水平的食管壁。大多数异物可通过软性内镜或食管镜取出,但由于该假牙嵌顿在食管壁,这些技术均未成功。因此,多学科团队决定采用经颈入路进行食管切开术。成功实施食管切开术并取出了尖锐的钩状物体。我们的病例强调了在通过微创技术取出异物失败的情况下,早期手术干预以预防穿孔和纵隔炎等并发症的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa30/11625113/038a2ff1b083/gr1.jpg

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