Fishbone Penetration through the Gastric Wall: A Possible But Unusual Cause of Dyspepsia

魚刺穿透胃壁可能引起長期消化不良症

田玠為(Kent Tain) ； 黎國洪(Kwok-Hung Lai) ； 沈明哲(Min-Tse Shen) ； 鄭錦翔(Jin-Shiung Cheng) ； 莫景棠(King-Tong Mok) ； 潘慧本(Huay-Ben Pan)

《中華民國消化系醫學會雜誌》 11卷2期 (1994/06) Pp. 158-162

https://doi.org/10.6557/GJTa.199406_11(2).0007

摘要

本文報告五十一歲女性因上腹不適，消化不良持續一年以上，經胃鏡及上消化道攝影檢查發現胃底部約3公分黏膜下腫瘤，但電腦斷層掃描同時發現在胃外有一線狀影像，於手術切除時，赫然發現一小魚刺在胃幽門外；取出魚刺，將胃壁小孔縫合，胃底部腫瘤經病理切片證實為良性平滑肌瘤，手術過程順利，術後症狀消失，本病例其胃底部平滑肌瘤只有3公分，應不致引起症狀，故推斷其胃部不適可能由魚刺穿透引起，患者之上腹不適，消化不良源因於異物穿孔殊為罕見，更由於年月久遠，患者已記不清楚異物吞入之病史，診斷此例實屬巧合，因此我們願強調，病人有消化不良，上腹不適之主訴時，異物吞入也應列人鑑別診斷之一。

關鍵字

消化不良 ； 異物 ； 胃腸道

並列摘要

We report a case of a 51-year-old female who suffered from abdominal discomfort and long-term dyspepsia for one year. Panendoscopy and upper gastrointestinal barium study only disclosed a submucosal tumor at the gastric fundus. Computerized tomographic scan confirmed this tumor, but another linear density near the ant rum was also noted. Wedge resection of the submucosal tumor was performed. During operation, a fishbone that had penetrated through the anterior wall of the gastric antrum was also found. After removal of the fishbone, simple closure of the perforated hole was performed. The resected tumor was proved to be leiomyoma pathologically. Symptoms subsided postoperatively. Although this patient had double lesions in the stomach, the fishbone penetration rather than the small leiomyoma seemed to be the major cause of the symptoms. In cases of long-term dyspepsia where the cause is unknown, foreign body ingestion should be included in the differential diagnosis.

並列關鍵字

dyspepsia ； foreign bodies ； gastrointestinal tract