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误吞鹅卵石11枚 4年后无创取出
2017-09-01 05:35:54 中国青年网
薛先生因精神疾病于4年前误食鹅卵石11枚,由于不愿意做当地医院建议的开腹取石手术,病情拖延至今。
因鹅卵石长时间滞留在身体内,薛先生的胃已被压迫到耻骨的位置,严重影响其正常进食,身体极其消瘦。日前,年过花甲的薛先生来京就诊。
胃镜检查显示,患者胃体大弯侧有多枚块状异物(石块),镜下可见多发溃疡瘢痕,胃窦及幽门变形,皱襞集中。北京友谊医院消化内镜中心主任医师俞力在为其做消化内镜检查时,使用医用网篮及网兜从胃内反复抓取石块,经过一个半小时,顺利取出直径3厘米至4厘米的鹅卵石共11枚。
专家提示,经口吞入的异物中有20%至30%会在食管内因受阻而滞留。80%以上的胃内异物可自行排出胃腔,自肠道排出体外,很少引起不适或只有轻微的上腹部隐痛、胀满、恶心等症状。异物较大时,可嵌塞于幽门、十二指肠空肠曲、回盲瓣等部位。
当异物阻塞于幽门时,病人常感上腹痛、腹胀、呕吐。异物会对胃肠黏膜造成直接损伤,若长期嵌塞,会造成局部黏膜糜烂溃疡,严重时可导致消化道出血。若吞入锐性异物(针状物),则可刺破胃肠壁而形成局限性小脓肿或肉芽肿,也有可能穿透胃肠壁而移至腹腔等部位。若异物引起胃肠穿孔,患者会出现腹膜炎的表现。因此,对于老人、小孩和有精神障碍者,家人应多关注他们的饮食起居,尽量避免他们误吞、误食异物。
(作者单位:北京友谊医院)
本版供图/视觉中国
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