A Fish Bone in Terminal Ileum Caused Impended Perforation and Peritonitis: An Unusual Case Report

迴腸末端魚刺腸穿孔致腹膜炎：病例報告

廖育聲(Yu-Sheng Liao) ； 簡旭霄(Hsun-Hsiao Chien) ； 林宗興(Tsung-Hsing Lin) ； 許宗鴻(Choon-Hoon Hii) ； 阮祺文(Chi-Wen Juan)

《弘光學報》 81期 (2018/03) Pp. 1-5

https://doi.org/10.6615/HAR.201803_(81).0001

摘要

The gastrointestinal tract perforation by an ingested fish bone is unusual, and the preoperative diagnosis is extremely difficult. Herein, we report a 66 year old woman who had a sudden onset of vomiting with abdominal cramping pain, especially localized at right lower quadrant after a meal. Computed tomography of the abdomen revealed a foreign body in the terminal ileum with impended intestinal perforation and localized peritonitis. She had immediate surgical intervention and a bony chip foreign body was removed from colon, partial colectomy with anastomosis was done successfully. This patient's clinical course was smooth and she was discharged back home in good condition. An early accurate diagnosis and rapid emergency surgical intervention may have greatly aided in the good results in this case.

關鍵字

intestinal perforation ； fish bone ； foreign body

並列摘要

因魚刺食入導致腸胃道穿孔並不常見，但要在手術之前正確診斷出來則相當困難。本文報告一位66歲女性病患於餐後隨即感到嘔吐併發異常腹絞痛侷限於右下腹部。經由腹部電腦斷層檢查發現其迴腸末端腸壁疑似有異物置入導致腸穿孔與腹膜炎跡象，因而進行緊急腹部外科手術。手術發現迴腸末端與大腸交界處因魚刺刺穿而破裂穿孔，從迴腸末端與大腸交界處取出魚刺，並切除部分大腸，成功進行部分結腸吻合術。此病患住院過程平順且順利出院。我們認為術前正確診斷與立即外科手術介入處置是病人達到良好預後最重要的因素。

並列關鍵字

腸穿孔 ； 魚刺 ； 異物

參考文獻

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