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Migration of a foreign body into the colon and its autonomous excretion

机译:异物移入结肠及其自主排泄

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Background:The frequency of foreign body retention in the abdominal cavity ranges from 1 in 100 to 1 in 3000 surgeries performed. Worldwide literature describes only a few cases of the migration of misplaced surgical gauze into the colon.Case Reports:The first case is a 60-year-old patient following laparoscopic cholecystectomy, who excreted (on his own) a cotton sheet 30×65 cm after 26 weeks, which did not possess a radiological locator. The latter fact caused diagnostic difficulties in interpreting ultrasonography, CT-scans and abdominal X-rays. Colonoscopy after 4 months following the excretion of the sheet showed flat, stretched ulceration of the colonic wall near the hepatic turn.The second case is a 76-year-old who had undergone several abdominal surgeries, including a classical cholecystectomy and extirpation of the uterus along with related tissues, as a result of cancer and with subsequent radiotherapy. The reason for the last intervention was an occlusion, which required a resection due to abscesses inside the peritoneal cavity. Abdominal pain continued after the surgery. Uroscopy and abdominal X-rays were performed 3 months later, which confirmed the presence of foreign matter in the abdominal cavity.Conclusions:Most foreign objects that have migrated into the colon will be excreted autonomously, which warrants a conservative assessment. Radiologically-tagged materials should be used, which will greatly ease identification in cases of suspected retention of surgical materials in the abdominal cavity.
机译:背景:异物滞留在腹腔中的频率范围为每100例中有1例到3000例中有1例。全世界的文献仅描述了放错位置的手术纱布迁移到结肠的几例病例报告:第一例是腹腔镜胆囊切除术后一名60岁患者,他(自己)排泄了一块30×65 cm的棉布26周后,该患者没有放射定位器。后一个事实在解释超声检查,CT扫描和腹部X射线检查时造成诊断困难。床单排泄后4个月后进行结肠镜检查,显示在肝转弯附近的结肠壁出现扁平的,延伸的溃疡。第二例是76岁的他接受了几次腹部手术,包括经典的胆囊切除术和子宫切除术以及相关组织,由于癌症和随后的放射治疗。最后一次干预的原因是阻塞,由于腹膜腔内脓肿需要切除。手术后腹部疼痛持​​续。 3个月后进行了泌尿镜检查和腹部X线检查,证实了腹腔中存在异物。结论:大多数已迁移到结肠的异物将自动排泄,因此需要进行保守评估。应使用放射标记的材料,如果怀疑将手术材料保留在腹腔中,将大大简化识别工作。

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