CUERPO EXTRAÑO PUNZANTE LOCALIZADO EN APÉNDICE CECAL, DE DOS MESES DE EVOLUCIÓN. EXTRACCIÓN POR COLONOSCOPIA - INFORME DE CASO.

Andrés Fernando Yépez, Iván Rolando Cadena, Neicy Graciela Correa
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Abstract

Introduction Ingestion of foreign bodies implies a 35% risk of possible complications, which are associated with their type (blunt or sharp) and their size. Although in most of them, it is expected that they pass along the gastrointestinal tract without difficulty or complications, the management will depend on the characteristics of the swallowed object, time of evolution and symptoms of the patient. Case description We present the clinical case of a 58-year-old female patient with a recent gastric bypass surgical history, who accidentally ingested a piece of dental equipment two months earlier during a dental procedure, remaining asymptomatic until she came to our office. In radiographic controls for confirmation, location and evolution, the presence of a 2 cm sharp object was evidenced, apparently located in the cecal appendix, which does not progress distally. For the management, initial expectant management was proposed, which was completed with therapeutic colonoscopy for its extraction, the technique recommends that the sharp object should be grasped by the pointed end, distal to the wall, which reduces the risk of perforation related to the procedure or damage of the mucosa during extraction, the case is completed with successful resolution and without complications. Conclusion Less invasive therapeutic management such as colonoscopy should be considered first line in this type of case, when there are no signs or radiological findings of perforation or clinical instability, due to its low incidence of complications and a high success rate.
盲肠阑尾有穿刺异物,发育两个月。结肠镜提取-病例报告。
摄入异物意味着35%的并发症风险,这与它们的类型(钝的或锋利的)和它们的大小有关。虽然在大多数情况下,预计它们沿胃肠道传递没有困难或并发症,但处理将取决于吞咽物体的特征,演变的时间和患者的症状。我们报告一位58岁女性患者的临床病例,她最近接受过胃旁路手术,两个月前在一次牙科手术中意外摄入了一件牙科设备,直到她来到我们的办公室才出现症状。在x线摄影检查中,证实了一个2厘米的尖锐物体的存在,显然位于盲肠阑尾,没有向远端发展。对于治疗方法,我们提出了最初的预期治疗方法,并在治疗性结肠镜下完成了拔牙,该技术建议用尖端抓住尖锐物体,远离肠壁,这减少了与手术相关的穿孔或拔牙过程中粘膜损伤的风险,该病例成功解决,无并发症。结论对于此类病例,在无穿孔征象或影像学表现或临床不稳定时,应考虑采用结肠镜检查等微创治疗,其并发症发生率低,成功率高。
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