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急诊室里的骨头:不仅仅是骨骼问题!一例罕见的毕罗Ⅱ式胃部分切除术后输入袢意外吞食鸡骨病例

Bone in emergency room: Not only a skeletal problem! A rare case of accidental chicken bone ingestion in the afferent loop following Billroth II partial gastrectomy.

作者信息

Gullì Consolato, Diego Mario Di, Mazzotta Giorgio, Cicchetti Giuseppe, Perla Daniele, Riccioni Maria Elena, Calbi Roberto, Luigi Natale

机构信息

Advanced Radiology Center, Department of Diagnostic Imaging and Radiation Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, Rome, Italy.

出版信息

Radiol Case Rep. 2025 Jul 22;20(10):5056-5060. doi: 10.1016/j.radcr.2025.06.122. eCollection 2025 Oct.

Abstract

We report the case of a 58-year-old male with prior Billroth II gastrectomy who presented with worsening abdominal pain. Contrast-enhanced CT revealed a hyperdense, corticated, triangular-shaped foreign body (FB), consistent with a chicken bone, which had undergone retrograde migration and become impacted in the afferent duodenal loop. The FB's orientation and location were precisely characterized, with associated inflammatory changes but no perforation. Push enteroscopy confirmed and successfully removed the FB. Post-procedural imaging excluded complications. This case highlights the diagnostic value of CT in identifying ingested FBs and illustrates the exceptional risk of retrograde FB migration and potential perforation in the afferent loop following Billroth II surgery.

摘要

我们报告了一例58岁男性患者,该患者曾接受毕Ⅱ式胃切除术,现出现腹痛加重症状。对比增强CT显示一个高密度、有包膜、三角形的异物(FB),与鸡骨相符,该异物发生了逆行迁移并嵌顿于十二指肠输入袢。精确描述了FB的方位和位置,伴有相关炎症改变但无穿孔。推进式小肠镜检查证实并成功取出了FB。术后影像学检查排除了并发症。该病例突出了CT在识别摄入异物方面的诊断价值,并说明了毕Ⅱ式手术后异物在输入袢逆行迁移及潜在穿孔的特殊风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41b5/12305705/0afcad1d63e8/gr1.jpg

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