乙状结肠刺入异物并保留7年的独特病例

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL
Iulia Cristina Pîrvulescu, Alfred Najm, Eduard Cristian Popa, A. Chiotoroiu, S. Crețoiu, B. Gașpar
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引用次数: 0

摘要

摄入异物是儿科、成人或老年精神病患者在急诊科就诊的常见原因。由于消化管上段或下段的阻塞或穿孔,吞咽异物有时对外科医生来说是一个巨大的挑战。偶尔,在消化管下部(结肠和直肠)检测到的异物可以通过肛门路径引入,有直肠或乙状结肠穿孔的风险。在本报告中,我们描述了一个独特的病例,异物位于乙状结肠,它是由于背后捅刀而到达的,并保留了7年,没有急性症状。43岁男性患者因左侧髂窝疼痛来到急诊科。在他的报告之前,计算机断层扫描(CT)检查显示异物。我们决定采取手术方式。手术以探查性腹腔镜开始,随后转为剑骨-耻骨切口,通过乙状结肠切开术取出异物(一块约8厘米长的玻璃),然后进行双层乙状结肠缝合。患者术后进展顺利。据我们所知,这是第一例在乙状结肠内放置异物玻璃体的病例它是通过刺伤而不是通过摄入或每年引入的。综上所述,我们建议在腹部检测到异物时,应考虑不同尖锐物体的攻击行为和腹壁穿透。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Unique Case of Foreign Body Acquired by Stabbing and Retained for 7 Years in the Sigmoid Colon
The ingestion of foreign bodies is a common cause for presentation in the emergency department by pediatric, adult, or elderly psychiatric patients. Swallowed foreign bodies sometimes represent a great challenge for surgeons due to the obstruction or perforation of the digestive tube’s upper or lower segments. Occasionally, the foreign bodies detected in the lower parts of the digestive tube (colon and rectum) could be introduced through the anal route with the risk of perforation of the rectum or sigmoid colon. In this report, we describe a unique case of a foreign body located in the sigmoid colon, where it arrived due to backstabbing and was retained for 7 years without acute symptoms. The 43-year-old male patient came to the emergency department with pain in the left iliac fossa. Before his presentation, a computerized tomography (CT) scan examination had suggested a foreign body. A surgical approach was decided. The surgery started as an exploratory laparoscopy and was converted to a xiphoid-pubic incision to extract the foreign body (a piece of glass about 8 cm long) through a sigmoid colotomy followed by a double-layer sigmoidorrhaphy. The postoperative evolution of the patient was uneventful. As far as we know, this is the first case of a patient with a foreign glass body positioned in the sigmoid colon that got there by stabbing and not by ingestion or introduced per anum. In conclusion, we suggest that aggressive behavior and abdominal wall penetration by different sharp objects should be considered when foreign bodies are detected in the abdomen.
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