ABSTRACT
Resumen La ingesta de cuerpos extraños es una entidad clínica común en el servicio de gastroenterología; la mayoría de veces estos pasan a través del tracto digestivo de manera espontánea y, en algunos casos, pueden presentar complicaciones como obstrucción o perforación. Es importante realizar un diagnóstico temprano con el fin de definir una terapia conservadora o quirúrgica inmediata. Se presenta el caso de una paciente de 67 años de edad que ingresó al servicio de urgencias por dolor abdominal de 16 días de evolución; como había sospecha de tumor gástrico sobreinfectado, se solicitó una endoscopia digestiva alta para la toma de biopsias, pero de forma sorpresiva se extrajo una espina de pescado de 3,5 cm sin complicaciones; posteriormente, se realizó el manejo del absceso gástrico con antibióticos por 14 días, con un buen desenlace clínico.
Abstract Foreign body ingestion is a common reason for consultation to the Gastroenterology Service. Most of these bodies pass through the digestive tract spontaneously and, in some cases, may cause complications such as obstruction or perforation. Early diagnosis is crucial to establish immediate conservative or surgical therapy. The following is the case of a 67-year-old patient admitted to the Emergency Department due to abdominal pain of 16 days of evolution. Since an over-infected gastric tumor was suspected, an upper gastrointestinal endoscopy was requested for biopsy. Strikingly, a 3.5cm fish bone was removed without complications. Gastric abscess was treated subsequently with antibiotics for 14 days, obtaining a good clinical outcome.
Subject(s)
Humans , Female , Aged , Gastrointestinal Tract , Foreign Bodies , Endoscopy, Gastrointestinal , Eating , Research Report , LiteratureABSTRACT
There are several cases of liver abscesses caused by the ingestion of a foreign body, especially in the elderly. Fish bones or chicken bones are sharp foreign bodies that can migrate through the digestive tract to the liver parenchyma. We reported a 71-year-old man who presented to the emergency department with fever and epigastric pain. Computed tomography scan showed a liver abscess related to a long and sharp foreign body which is protruding from the left lobe of the liver. Systemic antibiotic treatment was initiated and later the foreign body was removed by laparoscopic surgery.
Existen numerosos casos publicados en la literatura que muestran abscesos hepáticos producidos por la ingestión de un cuerpo extraño, especialmente en ancianos. Los huesos de pollo, y con mayor frecuencia las espinas de pescado, pueden perforar el tubo digestivo y migrar hasta el parénquima hepático y originar un absceso. Reportamos el caso de un paciente de 71 años que acude a urgencias por dolor epigástrico y fiebre. Se realizó tomografía computarizada abdominal, que identificó un absceso hepático junto con un cuerpo extraño puntiforme que penetraba en el hígado. El paciente fue intervenido quirúrgicamente, realizando drenaje del absceso y retirada del cuerpo extraño mediante abordaje laparoscópico.
Subject(s)
Foreign Bodies , Liver Abscess , Aged , Animals , Fishes , Foreign Bodies/complications , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Humans , Liver Abscess/diagnostic imaging , Liver Abscess/etiology , Male , Tomography, X-Ray ComputedABSTRACT
CONTEXT AND OBJETIVE: Fish bones (FB) are the most commonly ingested objects and the most common cause of foreign body perforation of the GI tract. Patients present with varied and nonspecific clinical presentations. The inability to obtain a history of FB ingestion and its wide spectrum of nonspecific clinical presentations makes dietary FB perforation extremely difficult to diagnose, being a laparoscopic or surgical diagnosis. The aim of our study is to describe radiological features in CT that will alert you to look for the FB and then make an accurate presurgical diagnosis. MATERIALS AND METHODS: All patients (n=58) with radiological diagnosis of gastrointestinal perforation caused by fish bone detected by CT between 2007 to 2017 were retrospectively reviewed. Inclusion criteria were: fish bone located beyond the esophagus, radiological diagnosis by CT and confirmation by surgery, endoscopy or radiological control. Descriptive analysis was made. Radiological features were studied including radioopaque foreign body, mural thickness, fatty infiltration or extraluminal air bubbles. Also potential complications were assessed. RESULTS: There were 58 patients, 39 men and 19 women, with an average age of 70. Ileon was the most frequent site of perforation (20 patients). 100% showed regional fatty infiltration, 98% included foreign body, 45% had mural thickening and 20% localized extraluminal air bubbles. 15 abscess were found (3 in the liver) and just 5 showed pneumoperitoneum. CONCLUSION: Fatty infiltration is the feature more common. Therefore, if fatty infiltration is seen in isolation radiologist should look for foreign body.
Subject(s)
Foreign Bodies/complications , Foreign Bodies/diagnostic imaging , Intestinal Perforation/diagnostic imaging , Intestinal Perforation/etiology , Stomach/diagnostic imaging , Stomach/injuries , Tomography, X-Ray Computed , Aged , Animals , Bone and Bones , Female , Fishes , Humans , Male , Retrospective StudiesABSTRACT
Los cuerpos extraños alojados en la vía aéreodigestiva superior son un motivo de consulta frecuente para el otorrinolaringólogo. Uno de los más frecuentes son las espinas de pescado. En raras ocasiones, éstas migran hacia tejidos adyacentes y generan complicaciones importantes. Presentamos el caso de una paciente que tras la ingesta de pescado manifiesta sensación de cuerpo extraño faríngeo, odinofagia y dolor látero cervical derecho. Dada la ausencia de hallazgos a la exploración física y laringoscópica se realiza una tomografia computarizada cervical, visualizando un cuerpo extraño alojado en la glándula tiroidea. Se interviene mediante cervicotomía media, realizando la extracción de la espina sin complicaciones. El diagnóstico precoz y manejo adecuado es determinante para prevenir complicaciones en estos casos.
Foreign bodies in the aerodigestive tract are commonly confronted in otolaryngology practice. The most frequent are the fish bones. In rare cases they can move and cause numerous complications. We report the case of a patient that manifest the sensation of pharyngeal foreign body, after fish ingestion. She also referred odynophagia and right cervical pain. Physical and laryngoscopic examination were normal. A cervical CT was performed, where a foreign body lodged in the thyroid gland was visualized, median cervicotomy was done and the foreign body was extracted. Early diagnosis and adequate management are crucial to prevent complications in these cases.
Subject(s)
Humans , Female , Middle Aged , Thyroid Gland/injuries , Foreign Bodies/surgery , Foreign Bodies/diagnostic imaging , Thyroid Gland/surgery , Bone and Bones , Tomography, X-Ray Computed , Foreign-Body Migration/surgery , Foreign-Body Migration/diagnostic imaging , SeafoodABSTRACT
RESUMEN Se presenta el caso de un paciente masculino de 39 años de edad, que acude al cuerpo de guardia del Hospital General Docente Abel Santamaría Cuadrado por presentar un cuadro de dolor abdominal de tres días de evolución. Se interviene quirúrgicamente con el diagnóstico presuntivo de apendicitis aguda complicada. En el acto quirúrgico se comprobó que el apéndice cecal era normal y al examinar el íleon terminal, a una distancia aproximada de 50 cm se encontró un divertículo de Meckel, y a 5 cm de este, una espina de pescado adherida a la pared intestinal, la cual parecía ser la causante del cuadro, ya que el divertículo también era normal. El tratamiento consistió en trasladar la espina hacia el divertículo y realizar resección intestinal de ese tramo con anastomosis término-terminal. La evolución posoperatoria fue satisfactoria y el paciente fue dado de alta a los 8 días de la operación(AU)
ABSTRACT We present the case of a male patient, 39 years of age, who presents to the emergency room of Abel Santamaría Cuadrado General Teaching Hospital with a clinical picture of abdominal pain of three days of natural history. He is surgically intervened with the presumptive diagnosis of complicated acute appendicitis. In the surgical act, the cecal appendix was verified to be normal and, when examining the terminal ileum, at a distance of approximately 50 cm, a Meckel's diverticulum was found, and, at 5 cm from this, a fish spine adhered to the intestinal wall, which seemed to be the cause of the clinical picture, since the diverticulum was also normal. The treatment consisted of transferring the spine to the diverticulum and performing intestinal resection of that section with end-to-end anastomosis. The postoperative evolution was satisfactory and the patient was discharged 8 days after the operation(AU)
Subject(s)
Humans , Male , Adult , Appendicitis/diagnosis , Abdominal Pain/etiology , Foreign Bodies/surgery , Intestine, Small/diagnostic imaging , Meckel Diverticulum/surgeryABSTRACT
La ingestión de cuerpos extraños durante la alimentación es frecuente, siendo en su mayoría espinas de pescado y huesos de pollo. En gran parte de los casos ocurre accidentalmente en personas alcohólicas, con enfermedad mental o que usan prótesis dentaria. Generalmente pasan a través del tubo digestivo sin causar daño y son expulsadas cerca de los 7 días de la ingestión, pero en algunos pacientes produce perforación del tubo digestivo, siendo las zonas más afectadas las regiones ileocecal y rectosigmoidea por su angulación. Presentamos un paciente masculino de 54 años de edad con perforación yeyunal por espina de pescado ingerida con 5 días de anterioridad, al que se le realizó sutura de la perforación, evolucionando satisfactoriamente.
The ingestion of foreign bodies during the intake is frequent; in the majority of the cases are fish or chicken bones. It generally occurs in alcoholics, mental illness patients or persons using dental prosthesis. Therefore its passes through the digestive tract without causing damage, a few patients present digestive perforation, and the most affected zones are the ileocecal and rectosigmoid regions. A patient with yeyunal perforation by fish bone ingested 5 days ago was presented. The patient required suture of perforation, the progress was satisfactory.
ABSTRACT
La ingestión de cuerpos extraños durante la alimentación es frecuente, siendo en su mayoría espinas de pescado y huesos de pollo. En gran parte de los casos ocurre accidentalmente en personas alcohólicas, con enfermedad mental o que usan prótesis dentaria. Generalmente pasan a través del tubo digestivo sin causar daño y son expulsadas cerca de los 7 días de la ingestión, pero en algunos pacientes produce perforación del tubo digestivo, siendo las zonas más afectadas las regiones ileocecal y rectosigmoidea por su angulación. Presentamos un paciente masculino de 54 años de edad con perforación yeyunal por espina de pescado ingerida con 5 días de anterioridad, al que se le realizó sutura de la perforación, evolucionando satisfactoriamente.(AU)
The ingestion of foreign bodies during the intake is frequent; in the majority of the cases are fish or chicken bones. It generally occurs in alcoholics, mental illness patients or persons using dental prosthesis. Therefore its passes through the digestive tract without causing damage, a few patients present digestive perforation, and the most affected zones are the ileocecal and rectosigmoid regions. A patient with yeyunal perforation by fish bone ingested 5 days ago was presented. The patient required suture of perforation, the progress was satisfactory.
