Ileal Perforation with Peritonitis Caused by a Fish Bone: Report of a Case

因魚刺穿刺所致之迴腸穿孔與腹膜炎：一病例報告

邱志文(Chih-Wen Chiu) ； 吳漢屏(Han-Ping Wu)

《中華民國急救加護醫學會雜誌》 20卷1期 (2009/03) Pp. 40-44

https://doi.org/10.30018/JECCM.200903.0005

摘要

因魚刺穿刺所致之小腸穿孔並不常見，但要在手術之前診斷出來則更加困難。本文報告一位91歲男性病患於前一天晚餐之後感到上腹疼痛以及腹部肌肉僵硬。經由電腦斷層檢查發現其迴腸壁增厚且有金屬般異物置入，同時，由於無法排除小腸穿孔與腹膜積氣，因而進行緊急外科手術。手術發現迴腸因魚刺刺穿而破裂並伴有混濁之腹水，部分迴腸也因而遭切除。此病患最後順利出院且住院過程十分平順。我們因而認為正確診斷與立即外科手術介入是達到良好預後最重要的因素。

關鍵字

迴腸穿孔 ； 魚刺 ； 診斷

並列摘要

Small bowel perforation by a fish bone is unusual, and the preoperative diagnosis is difficult. We report a 91-year-old man who had a sudden onset of upper abdominal pain with muscle guarding after a meal. Computed tomography of the abdomen revealed a thickened ileum, and with suspicion of a metal foreign body in the intestine, together with multiple gallbladder stones and cholecystitis. Also, intestinal perforation and pneumoperitoneum could not be ruled out. He had immediate surgical intervention and an ileal perforation caused by a fish bone with turbid ascites was diagnosed. A partial resection of the small intestine and cholecystectomy were performed. The patient’s hospital course was smooth and he was discharged home in good condition. An accurate diagnosis and emergency surgical intervention may have aided in the good results in this case.

並列關鍵字

intestinal perforation ； fish bone ； diagnosis