An Unusual Cause of Perianal Sepsis Due to Ingested Fish Bone: Case Report and Review of the Literature

誤食的異物是一個經常遇到的手術狀況。如果誤食的異物是尖銳的，則可能發生消化道穿孔。本文報告一例罕見病例，因誤食魚刺引發肛門膿瘍而接受手術治療的病人。我們在此報告並回顧文獻，對於不尋常且罕見的肛門膿瘍，術前的電腦斷層診斷可以提供膿瘍感染範圍的臨床訊息，但未必能在影像上準斷出異物；因魚刺穿刺所造成的肛門膿瘍，須憑藉著詳細的術前病史詢問及術中仔細的觸診膿瘍腔室，方可找出鑲嵌的異物。適當的膿瘍切開引流和豬尾巴導管引流是一種可行的替代方法來治療複雜性肛門膿瘍。這種治療方式可以達到有效治療、控制感染、減少過長的傷口切口，並立即緩解疼痛。

關鍵字

肛門膿瘍；魚刺

並列摘要

We present a rare case of a peri-anal abscess caused by an ingested fish bone. A 53-year-old man in good health, without underlying disease presented with progressive and painful peri-anal swelling for 5 days, associated with fever. Physical examination revealed erythema, swelling, and local tenderness on the left side of the anus, with extension to the perineum and opposite side of the anus. Abdominal CT scan showed a gasforming abscess with infiltration into the perineal, perianal, perirectal, perivesical, and prevesical space, with soft-tissue swelling and hyperemic change. The right portion of the bulb/crura/corpus cavernosa and corpus spongiosum of the penis also was involved, compatible with Fournier gangrene. During incision and drainage, a 2.4 cm fish bone was found inside the abscess cavity. The patient recalled having eaten fish around one week prior to this admission. Ingestion of a sharp object can cause perforation of the gastrointestinal tract, not only the upper tract, but even the lower tract and anal canal. A high index of suspicion is needed in cases with a history of foreign body ingestion presenting with ischio-rectal abscess, to aid diagnosis and to prevent progression to Fournier gangrene.

並列關鍵字

Perianal sepsis ； Fish bone

國際替代計量

An Unusual Cause of Perianal Sepsis Due to Ingested Fish Bone: Case Report and Review of the Literature

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