现在的位置: 首页临床影像, 临床话题>正文
[NEJM临床医学影像]:鱼刺导致的肠穿孔
2019年09月06日 临床影像, 临床话题 暂无评论

IMAGES IN CLINICAL MEDICINE

Fish Bone Perforation

Takafumi Taguchi and Hiroyuki Kitagawa

N Engl J Med 2019; 381:762
DOI: 10.1056/NEJMicm1900442

A 73-year-old man presented to the emergency department with the acute onset of severe lower abdominal pain. He recalled eating yellow-tail fish the day before the onset of the pain. His temperature was 38°C, blood pressure 122/69 mm Hg, and heart rate 77 beats per minute. On physical examination, he had tenderness across the lower abdomen with rebound tenderness. Laboratory tests showed a white-cell count of 10,300 per cubic millimeter (reference range, 3300 to 8600) with 83% neutrophils. Computed tomography of the abdomen revealed a thickened gut wall and penetration of the small intestine by a linear, high-density body (Panel A). Laparotomy revealed a small-bowel perforation from a fish bone 2 cm in length (Panel B). Small-bowel resection was performed, and the patient received treatment with antibiotic agents. The postoperative course was uncomplicated, and the patient was discharged home on day 8 after surgery.

一名73岁男性患者因急性发作的严重下腹部疼痛到急诊科就诊。患者回忆在疼痛发生前一天曾进食黄尾鱼。患者体温38°C,血压122/69 mm Hg,心率77 bpm。体格检查发现,患者下腹部压痛及反跳痛。实验室检查显示,白细胞计数10,300 /ml(参考值范围 3300 to 8600),中性粒细胞 83%。腹部CT扫描发现肠壁增厚,有一高密度异物致小肠穿孔(图A)。剖腹探查发现长度为2 cm的鱼刺导致小肠穿孔(图B)。遂行小肠切除,且给予抗生素治疗。术后患者恢复顺利,术后第8天患者出院回家。

给我留言

您必须 [ 登录 ] 才能发表留言!

×
腾讯微博