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Gastrointestinal Tract Perforations Due to Ingested Foreign Bodies; A review of 21 cases

机译:摄入异物引起的胃肠道穿孔;审查21例

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Aim: To study the etiology, presentation and complications of Gastrointestinal tract (GIT) perforations due to ingestion of foreign bodies. Methods: A retrospective review of 21 patients with perforations in the GIT due to foreign body ingestion was done in the Department of General Surgery Sher-i-Kashmir Institute of Medical Sciences Srinagar (SKIMS) from January 2002 to December 2011.Data was reviewed in terms of the type and nature of the foreign objects, mode of entry into the gastrointestinal (GIT), preoperative diagnosis, perforation site, and treatment received. Results: 66.6% of patients were males with age ranging from 7 to 82 years and a median age of 65 years. A definitive preoperative history of foreign body ingestion was obtained in 4 (19.04%) of the 21 patients. The mean time from ingestion to presentation was 9.3 days. The various foreign bodies recovered were chicken bones in 10 (47 %), fish bones in 7 (33.33%), toothpick in 2 (9.5%) and metallic staple in 2 (9.5%) patients. A preoperative diagnosis of acute abdomen of uncertain origin was given in 12 (57.14%) of the 21 patients. Site of involvement in decreasing order of frequency was ileum in 14 (66.6%), colon in 5 (23.8%) and jejunum in 2 (9.5%) patients. Commonest surgery done on these patients was emergency laparotomy with primary repair in 11 (52.38%) and intestinal resection with ileostomy in 10 (47.6%) patients. Complication in terms of surgical site infection was seen in 3 (14.28%) patients and 2 (9.5%) deaths were recorded. Conclusion: Dietary foreign body is the most commonly ingested object giving rise to GIT perforation. Treatment consists of surgery and antibiotics. Patients are rarely aware of foreign body ingestion and a high index of suspicion is required to make a diagnosis of ingested foreign body in all acute abdomen conditions particularly at extremes of age as seen in the results.
机译:目的:研究因摄入异物引起的胃肠道(GIT)穿孔的病因,表现和并发症。方法:回顾分析2002年1月至2011年12月在斯利那加市谢里-克什米尔医学科学研究所(SKIMS)的21例因异物摄入引起的GIT穿孔的患者。异物的类型和性质,进入胃肠道(GIT)的方式,术前诊断,穿孔部位和所接受的治疗。结果:66.6%的患者是男性,年龄在7至82岁之间,中位年龄为65岁。在21例患者中有4例(19.04%)获得了明确的术前异物摄入史。从摄入到出现的平均时间为9.3天。所发现的各种异物为:鸡骨头(10%(47%),鱼骨头(7.33.33%),牙签(2%(9.5%))和金属钉书钉(2%)(9.5%)。 21例患者中有12例(57.14%)进行了术前诊断为不确定来源的急性腹部。频率降低的受累部位是回肠14例(66.6%),结肠5例(23.8%)和空肠2例(9.5%)。这些患者最常见的手术是紧急开腹手术,其中有11例(52.38%)进行了一次初次修复,有10例(47.6%)的患者采用了回肠造口术进行了肠切除。在3名(14.28%)患者中观察到了手术部位感染的并发症,并且有2名(9.5%)死亡。结论:饮食异物是引起GIT穿孔的最常见摄入对象。治疗包括手术和抗生素。患者很少意识到异物的摄入情况,因此需要很高的怀疑度才能诊断出在所有急性腹部疾病(尤其是极端年龄)中所摄入的异物,如结果所示。

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