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Mirzamohamadi S, HajiAbbasi MN, Baigi V, Salamati P, Rahimi-Movaghar V, Zafarghandi M, Isfahani MN, Fakharian E, Saeed-Banadaky SH, Hemmat M, Sadrabad AZ, Daliri S, Pourmasjedi S, Piri SM, Naghdi K, Yazdi SAM. Patterns and outcomes of patients with abdominal injury: a multicenter study from Iran. BMC Emerg Med 2024; 24:91. [PMID: 38816710 PMCID: PMC11141001 DOI: 10.1186/s12873-024-01002-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Injury is one of the leading causes of death worldwide, and the abdomen is the most common area of trauma after the head and extremities. Abdominal injury is often divided into two categories: blunt and penetrating injuries. This study aims to determine the epidemiological and clinical characteristics of these two types of abdominal injuries in patients registered with the National Trauma Registry of Iran (NTRI). METHODS This multicenter cross-sectional study was conducted with data from the NTRI from July 24, 2016, to May 21, 2023. All abdominal trauma patients defined by the International Classification of Diseases; 10th Revision (ICD-10) codes were enrolled in this study. The inclusion criteria were one of the following: hospital length of stay (LOS) of more than 24 h, fatal injuries, and trauma patients transferred from the ICU of other hospitals. RESULTS Among 532 patients with abdominal injuries, 420 (78.9%) had a blunt injury, and 435 (81.7%) of the victims were men. The most injured organs in blunt trauma were the spleen, with 200 (47.6%) and the liver, with 171 (40.7%) cases, respectively. Also, the colon and small intestine, with 42 (37.5%) cases, had the highest number of injuries in penetrating injuries. Blood was transfused in 103 (23.5%) of blunt injured victims and 17 (15.2%) of penetrating traumas (p = 0.03). ICU admission was significantly varied between the two groups, with 266 (63.6%) patients in the blunt group and 47 (42%) in penetrating (p < 0.001). Negative laparotomies were 21 (28%) in penetrating trauma and only 11 (7.7%) in blunt group (p < 0.001). In the multiple logistic regression model after adjusting, ISS ≥ 16 increased the chance of ICU admission 3.13 times relative to the ISS 1-8 [OR: 3.13, 95% CI (1.56 to 6.28), P = 0.001]. Another predictor was NOM, which increased ICU chance 1.75 times more than OM [OR: 1.75, 95% CI (1.17 to 2.61), p = 0.006]. Additionally, GCS 3-8 had 5.43 times more ICU admission odds than the GCS 13-15 [OR:5.43, 95%CI (1.81 to 16.25), P = 0.002] respectively. CONCLUSION This study found that the liver and spleen are mostly damaged in blunt injuries. Also, in most cases of penetrating injuries, the colon and small intestine had the highest frequency of injuries compared to other organs. Blunt abdominal injuries caused more blood transfusions and ICU admissions. Higher ISS, lower GCS, and NOM were predictors of ICU admission in abdominal injury victims.
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Affiliation(s)
- Sara Mirzamohamadi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
| | | | - Vali Baigi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
- Department of Epidemiology and Biostatics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Payman Salamati
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
| | - Mohammadreza Zafarghandi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
| | - Mehdi Nasr Isfahani
- Trauma Data Registration Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Esmaeil Fakharian
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Seyed Houssein Saeed-Banadaky
- Trauma Research Center, School of Medicine, Rahnemoon Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Akram Zolfaghari Sadrabad
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Salman Daliri
- Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sobhan Pourmasjedi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
| | - Seyed Mohammad Piri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran
| | - Seyed Amir Miratashi Yazdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Science, Tehran, 1136746911, Iran.
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Aljehaiman F, Almalki FJ, Alhusain A, Alsalamah F, Alzahrani K, Alharbi A, Alkhulaiwi H. Prevalence, Pattern, Mortality, and Morbidity of Traumatic Small Bowel Perforation at King Abdulaziz Medical City: A Retrospective Cohort Study. Cureus 2024; 16:e52313. [PMID: 38357047 PMCID: PMC10866392 DOI: 10.7759/cureus.52313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction Bowel perforation, whether from trauma or other causes, presents with diverse clinical scenarios. Small bowel perforation (SBP), a potentially fatal condition often linked to blunt trauma like motor vehicle accidents, necessitates prompt detection and intervention, crucial for improved outcomes. This study investigated the prevalence, predictors, presentation, diagnostic findings, morbidity, and mortality of traumatic SBP for comprehensive insights. Methodology This was a retrospective cohort study conducted at King Abdulaziz Medical City, Riyadh. A review of 838 cases, which represent all abdominal trauma patients from January 2017 to March 2023, was done. Forty patients who developed SBP and have complete data were included in this study. One case was excluded due to incomplete medical records. Data were collected with the non-probability convenience sampling technique via the BestCare system using a data collection sheet. Data were analyzed with IBM SPSS 29 (IBM Corp., Armonk, NY). Results Out of all abdominal trauma cases (n=838), 40 patients developed SBP (n=40, 4.77%). Males constituted 87.5%, and the most common mechanism was motor vehicle accidents (57.5%). Complications included cardiac arrest, disseminated intravascular coagulation (DIC), and leak (7.5% each). In motor vehicle accidents, SBP primarily affected patients who were in the driver's position (78.3%). Clinical signs at presentation revealed abdominal tenderness (52.5%), abdominal distension (22.5%), and abnormal systolic blood pressure (mean 115.3 mmHg). Linear regression showed gender and age positively associated with morbidity (p=0.474, p=0.543) while BMI exhibited a negative relationship (p=0.314). Logistic regression revealed non-significant predictors of mortality, except for mean initial hematocrit (HCT) (p=0.721, aOR=0.098). Conclusion Our study provides crucial findings on the incidence, patterns, mortality, and morbidity of traumatic bowel perforation, contributing to the existing body of research. The identified prevalence of 4.77% and mortality at 17.5% from the studied population underline the serious impact of this condition, and the 37.5% complication rate observed demonstrates the potential risks involved. The average hospital stay is found to be 14 days, adding further to the disease burden. These findings underscore the importance of specific preventative measures, particularly related to motor vehicle accidents (MVAs), and highlight potential markers for predicting outcomes, such as age, gender, and mean initial HCT. This substantiates the need for further research involving larger cohorts and prospective designs to gain comprehensive insights and establish more robust preventative and treatment strategies.
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Affiliation(s)
- Fahad Aljehaiman
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Faisal J Almalki
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdulah Alhusain
- Plastic and Reconstructive Surgery, King Abdulaziz Medical City, Riyadh, SAU
| | - Faris Alsalamah
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | | | - Hani Alkhulaiwi
- Trauma and Acute Care Surgery, King Abdulaziz Medical City, Riyadh, SAU
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Tardalkar K, Patil S, Chaudhari L, Kshersagar J, Damle M, Kawale A, Bhamare N, Desai V, Pathak N, Gaikwad V, Joshi MG. Decellularized small intestine scaffolds: a potential xenograft for restoration of intestinal perforation. Tissue Barriers 2023:2290940. [PMID: 38053224 DOI: 10.1080/21688370.2023.2290940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023] Open
Abstract
Small intestine perforation is a serious medical condition that requires immediate medical attention. The traditional course of treatment entails resection followed by anastomosis; however, it has complications such as small bowel syndrome (SBS), anastomotic leakage, and fistula formation. Here, a novel strategy is demonstrated, that utilizes the xenogeneic, decellularized goat small intestine as a patch for small intestine regeneration in cases of intestinal perforation. The goat small intestine scaffold underwent sodium dodecyl sulfate decellularization, which revealed consistent, quick, and effective decellularization. Decellularization contributed the least amount of extracellular matrix degradation while maintaining the intestinal architecture. By implanting the decellularized goat small intestine scaffolds (DGSIS) on the chorioallantoic membrane (CAM), no discernible loss of angiogenesis was seen in the CAM region, and this enabled the DGSIS to be evaluated for biocompatibility in ovo. The DGSIS was then xeno-transplanted as a patch on a small intestine perforation rat model. After 30 days post transplant, barium salt used as contrast gastrointestinal X-ray imaging revealed no leakage or obstruction in the small intestine. Histology, scanning electron microscopy, and immunohistochemistry assisted in analyzing the engraftment of host cells into the xeno patch. The xeno-patch expressed high levels of E-cadherin, α-smooth muscle actin (α-SMA), Occludin, Zonnula occluden (ZO-1), Ki 67, and Na+/K+-ATPase. The xeno-patch was consequently recellularized and incorporated into the host without causing an inflammatory reaction. As an outcome, decellularized goat small intestine was employed as a xenograft and could be suitable for regeneration of the perforated small intestine.
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Affiliation(s)
- Kishor Tardalkar
- Department of Stem Cells & Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, MS, India
| | | | | | - Jeevitaa Kshersagar
- Department of Stem Cells & Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, MS, India
| | | | | | - Nilesh Bhamare
- Department of Stem Cells & Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, MS, India
| | - Vaishnavi Desai
- Department of Stem Cells & Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, MS, India
| | - Narayani Pathak
- Department of Stem Cells & Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, MS, India
| | - Vaishali Gaikwad
- Department of Surgery, Dr. D Y Patil Medical College, Hospital and Research Institute, Kolhapur, India
| | - Meghnad G Joshi
- Department of Stem Cells & Regenerative Medicine, D. Y. Patil Education Society (Deemed to be University), Kolhapur, MS, India
- Stem Plus Biotech, Sangli, MS, India
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Muacevic A, Adler JR, Al Dhneem HN, AlZahid AA, Alfaraj D. Late Presentation of Peritonitis Post Jejunal Perforation Due to Flank Stab Wound. Cureus 2022; 14:e31351. [PMID: 36514649 PMCID: PMC9741703 DOI: 10.7759/cureus.31351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/13/2022] Open
Abstract
Abdominal trauma injuries are caused by many mechanisms including blunt and penetrating trauma injuries. Penetrating injuries are far more common than blunt injuries. Subsequently, the most affected organ during such injuries is small intestine perforations. As far as we know, there were no cases reported before about jejunal injury due to penetrating trauma. We present a case of a 20-year-old male with a stab wound injury who was initially stable in the emergency department (ED). After a set of investigations were done, the patient was discharged home. Yet, the patient presented again with late signs of peritonitis. Imaging was done and showed pneumoperitoneum. Thereafter, the patient was rushed to the operation room (OR) where the jejunal repair was performed. ED physicians must be vigilant regarding any signs of deterioration in penetrating trauma patients and should provide clear instructions to patients regarding any symptoms of the acute abdomen before any discharge.
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Yang X, Tang N, Li L, Xu G, Dai J, Tao K, He C, Huangfu C. Management of a patient with cardiac arrest, intestinal ischemia necrosis, multiple fractures, hemorrhagic shock, renal failure, disseminated intravascular coagulation, and thrombosis after severe abdominal crush injury: A case report. Exp Ther Med 2022; 23:386. [PMID: 35495585 PMCID: PMC9019741 DOI: 10.3892/etm.2022.11313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/28/2022] [Indexed: 11/06/2022] Open
Abstract
Abdominal crush injury has been widely reported. However, abdominal crush injury cases involving most of the organ systems have seldom been reported. In the present case report, a 58-year-old man was hit in the abdomen by a 4-ton machine tool. The case described a rare combination of cardiac arrest, intestinal ischemia necrosis, multiple fractures, hemorrhagic shock, renal failure, disseminated intravascular coagulation and thrombosis after severe abdominal crush injury. During the treatment, crush syndrome, anemia, electrolyte disorder, pleural effusion, pulmonary emphysema, compartment syndrome, respiratory failure, pulmonary hemorrhage, injury of the right common peroneal nerve and tibial nerve, septum abscess and malnutrition were also observed. Systemic and symptomatic treatments were performed for >3 months, after which the patient was discharged from hospital without any further risk of fatality. The related treatments were also described in detail in the present case report. This case represented one of the most complicated cases among abdominal crush injuries that have been reported, and the treatment experiences reported here will hopefully provide suitable reference points for similar cases.
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Affiliation(s)
- Xiaokun Yang
- Department of Emergency Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China
| | - Nan Tang
- School of Nursing, Lanzhou University, Lanzhou, Gansu 730010, P.R. China
| | - Le Li
- Department of Emergency Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China
| | - Guisen Xu
- Department of Emergency Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China
| | - Juan Dai
- Department of Emergency Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China
| | - Kai Tao
- Department of Emergency Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China
| | - Chunyang He
- Department of Hyperbaric Oxygenation Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan 610083, P.R. China
| | - Chaoji Huangfu
- Center for Disease Control and Prevention, Western Theater Command, Lanzhou, Gansu 730020, P.R. China
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Yoon JH, Jun CH, Han JP, Yeom JW, Kang SK, Kook HY, Choi SK. Endoscopic repair of delayed stomach perforation caused by penetrating trauma: A case report. World J Clin Cases 2021; 9:1228-1236. [PMID: 33644189 PMCID: PMC7896642 DOI: 10.12998/wjcc.v9.i5.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/13/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary endoscopic closure of a perforated gastric wall during endoscopic procedures is mostly effective and well-tolerated; however, there are very few studies on the efficacy of endoscopic management of delayed traumatic gastric perforation. Herein, we report a novel case of a patient who was successfully treated for delayed traumatic stomach perforation using an alternative endoscopic modality.
CASE SUMMARY A 39-year-old woman presented with multiple penetrating traumas in the back and left abdominal cavity. Initial imaging studies revealed left diaphragmatic disruption and peri-splenic hemorrhage without gastric perforation. An emergency primary repair of the disrupted diaphragm with omental reduction and suturing of the lacerated lung was performed; however, delayed free perforation of the gastric wall was noted on computed tomography after 3 d. Following an emergency abdominal surgery for the primary repair of the gastric wall, re-perforation was noted 15 d postoperatively. The high risk associated with re-surgery prompted an endoscopic intervention using 2 endoloops and 11 endoscopic clips using a novel modified purse-string suture technique. The free perforated gastric wall was successfully repaired without additional surgery or intervention. The patient was discharged after 46 d without any complications.
CONCLUSION Endoscopic closure with endoloops and clips can be a useful therapeutic alternative to re-surgery for delayed traumatic gastric perforation.
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Affiliation(s)
- Jae Hyun Yoon
- Department of Gastroenterology and Hepatology, Chonnam National University Hospital and College of Medicine, Gwangju 61469, South Korea
| | - Chung Hwan Jun
- Department of Internal Medicine, Mokpo Hankook Hospital, Mokpo 58643, South Korea
| | - Jae Pil Han
- Department of Internal Medicine, Mokpo Hankook Hospital, Mokpo 58643, South Korea
| | - Ji-Woong Yeom
- Department of Surgery, Mokpo Hankook Hospital, Mokpo 58643, South Korea
| | - Seung-Ku Kang
- Department of Cardiothoracic Surgery, Mokpo Hankook Hospital, Mokpo 58643, South Korea
| | - Hyun Yi Kook
- Department of Nursing, Chonnam National University Hospital, and College of Nursing, Gwangju 61469, South Korea
| | - Sung Kyu Choi
- Department of Gastroenterology and Hepatology, Chonnam National University Hospital and College of Medicine, Gwangju 61469, South Korea
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Abstract
Gastrointestinal (GI) leak is a well-known and catastrophic surgical complication. Its impact on patients, surgeons, and the healthcare system is tremendous. Efforts to constraint the occurrence and consequences of GI leak contributed to better assessment and management planning, especially with advanced technology. Detail information about the problem extent and new management options became available and effective for specific categories. Therefore, a full and accurate assessment and understanding of the disease presentation assists in choosing the appropriate management plan. The pathophysiologic process encompasses a severe inflammatory process with a superimposed infection inside sterile body tissue and cavities initiated by contaminated GI leaked content. The extent of the morbidity resulting from GI perforation and leak is variable and may not be predictable. Leak might not be the same in every case. Patients with GI leak present at variable severity depending on several factors. Accordingly, management should be individualized to target the underlying pathophysiology and the extent of the complication. Operative intervention and repair of the perforation site surgically or endoscopically are the standard of care frequently used. However, it may not always be needed. In this article, a practical review of the diversity and underlying pathologies of GI leak will be presented to inform case-specific management plans.
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Affiliation(s)
- Faiz Tuma
- General Surgery, Central Michigan University College of Medicine, Saginaw, USA
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Feng L, Hu YL, Ma P, Feng Y, Guo YB, Huang H, Li P, Mao QS, Xue WJ. Decellularized gastric matrix as a mesh for gastric perforation repair. J Biomed Mater Res B Appl Biomater 2020; 109:451-462. [PMID: 32841467 DOI: 10.1002/jbm.b.34713] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/16/2020] [Accepted: 08/12/2020] [Indexed: 11/10/2022]
Abstract
The development of novel materials with effective defect-repairing properties will help avoid subtotal gastrectomy in patients with large gastric perforations. We prepared perfused decellularized gastric matrix (PDGM) and analyzed its components, spatial structure, biomechanics, cytotoxicity, and histocompatibility to validate its efficacy in the repair of gastric perforation. PDGM retained large amounts of gastric extracellular matrix, while residual glandular cells and muscle fibers were not found. The spatial structure of the tissue was well preserved, while the DNA and glycosaminoglycan contents were significantly decreased compared with normal gastric tissue (p < .01). There was no obvious deformation of the spatial structure and tissue elasticity of PDGM after sterilization by Cobalt-60 irradiation. The PDGM had good histocompatibility. PDGM was then used to repair a rat gastric perforation model. Radiography of the upper gastrointestinal tract at 24 hr postoperatively revealed no contrast agent leakage. There was evidence of early fibroblast proliferation, which was complicated by capillary regeneration. The hyperplastic gastric gland was slightly disarranged after repair. Defects of the muscular layer also healed a little with the regeneration process. PDGM is a nontoxic biocompatible biological mesh that may be useful for repairing relatively large gastric defects.
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Affiliation(s)
- Liang Feng
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, Jiangsu, China.,Department of Burns and Plastic Surgery, Nantong Third People's Hospital, Nantong University, Nantong, Jiangsu, China
| | - Yi-Lin Hu
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, Jiangsu, China.,Research Center of Clinical Medicine, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Peng Ma
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Ying Feng
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Yi-Bing Guo
- Research Center of Clinical Medicine, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Hua Huang
- Department of Pathology, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Peng Li
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Qin-Sheng Mao
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
| | - Wan-Jiang Xue
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, Jiangsu, China.,Research Center of Clinical Medicine, Nantong University Affiliated Hospital, Nantong, Jiangsu, China
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Management of Small Bowel Perforation by a Bizarre Foreign Body in a 55-Year-Old Woman. Case Rep Surg 2018; 2018:2781353. [PMID: 30298113 PMCID: PMC6157170 DOI: 10.1155/2018/2781353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/12/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction Ingestion of foreign bodies including dentures, fishbone, screw, and/or surgical devices can be a cause of morbidity, and it rarely could be fatal. Presentation of Case We present the first hitherto reported case of mussel shell ingestion, which caused acute abdominal pain in a 55-year-old woman. The shell pierced ileal loops, and it was found in the abdominal cavity. Discussion The accidental or voluntary ingestion of a foreign body is an uncommon event compared to the other causes of bowel perforation. It is fundamental to immediately remove the intestinal fluid, repair the tear, and prevent sepsis, because each delay in diagnosis can lead to a worst outcome. Conclusion In case of bowel perforation, it important for surgeons, who are dealing with these acute care patients, to be aware of different designs and constructions of possible foreign bodies, in order to be prepared to deal with different possible scenarios and be able to manage them properly.
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