Silent Perforations of the Stomach and Duodenum by Needles

Hashmonai, M; Kaufman, Theodor; Schramek, A

doi:10.1001/archsurg.1978.01370240028004

Cited by 44 publications

(31 citation statements)

References 17 publications

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“…Only during the longer stay in the hospital did the patient slowly develop the symptoms of appendicitis and finally the symptoms of a perforation. It seems to be typical for the clinical course that patients having a perforated appendix caused by a foreign body – in our case a needle – are relatively asymptomatic with only mild pain in the right hypogastrium [16]. This was also found in another case of silent perforation of the intestine by a needle [13]where the patient had only few symptoms early after perforation.…”

Section: Discussionsupporting

confidence: 59%

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Needle Perforation of the Appendix

et al. 2000

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Background/Aims: Needles are among the most frequently swallowed foreign bodies. In most cases they are excreted per vias naturales, but in some cases needles can lead to perforation of the stomach or duodenum in adults. Methods: We report a case of acute appendicitis after perforation of the appendix by a swallowed needle. An appendectomy was performed without any knowledge of the reason for perforation. Results: Inspection of the resected appendix demonstrated a needle of 1.5 cm length inside the lumen of the appendix, which had caused a perforation of the distal end of the appendix. Conclusion: As seen in this case a longer-lasting nondiagnosed perforation can lead to extensive local inflammation which could have been avoided by early surgical treatment which should also be considered if the patient has very few symptoms, as in this case.

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Section: Discussionsupporting

confidence: 59%

“…Patients should not be dismissed from the hospital, because normally there are no early clinical signs of perforation caused by the foreign body. If repeated plain abdominal roentgenograms show no progression of the foreign body, a perforation should be suspected and a contrast media swallow should be performed as soon as possible [16]. …”

Section: Discussionmentioning

confidence: 99%

Needle Perforation of the Appendix

et al. 2000

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“…25 A pesar de la perforación de víscera hueca algunos pacientes permanecen asintomáticos, como reportan Hashimonai y cols en un paciente con perforación duodenal por agujas. 26 Desde el punto de vista diagnóstico una radiografía de cuello, tórax y abdomen debe ser realizada al ingreso y orientada según la clínica del paciente. De presentarse asintomático recomendamos solicitarlas todas.…”

Section: Discussionunclassified

Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados

Trostchansky¹,

Masaferro²

2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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OEl 80-90% de los cuerpos extraños ingeridos voluntaria o accidentalmente se evacuan espontáneamente, sin embargo se requiere de una endoscopia terapéutica en un 10-20% de los casos y de cirugía en menos del 1% de los mismos.Objetivo: Analizar las características de los pacientes asistidos por ingesta de cuerpo extraño en el Departamento de Emergencia del Hospital Maciel y llegar al diseño de guías de actuación en el contexto de un equipo multidisciplinario.Resultados: Nuestra serie constó de 31 consultas por ingesta de cuerpo extraño. El 52% provenía de instituciones psiquiátricas y el 42% eran reclusos, un caso no pertenecía a ninguna de las 2 categorías. El 27,5% de las consulta se habían producido en las primeras 24hs desde la ingesta, el 24% de las ingestas se habían producido con más de una semana desde la ingesta y el resto oscilaba entra ambos tiempos evolutivos En cuanto a la conducta, en 12 casos se otorgó el alta sin mediar conducta activa endoscópica y/o quirúrgica. Se realizó una FGC en el 64% de los casos en los cuales se constató radiológicamente la ingesta de un cuerpo extraño, siendo efectivamente terapéuticas para la extracción de objetos a nivel gastroduodenal en el 67% de las mismas. De las 28 consultas por ingesta de CE 6 pacientes (21%) fueron operados. En 5 de ellos por falla de la extracción endoscópica, el restante se presentó como una peritonitis aguda. La ingesta de CE representa una patología de consulta frecuente en el Departamento de Emergencia. El manejo del mismo se realiza mediante un abordaje multidisciplinario que en el caso de nuestra serie mostró porcentajes de extracción endoscópica efectiva cercana al 70% comparable con otras series internacionales. El análisis de las características de la población analizada y el análisis de la evidencia científica publicada nos permite plantear un protocolo de actuación. Palavras Source of support: Nil Conflict of interest: None ABSTRACTAbout 80 to 90% of foreign bodies ingested voluntarily or accidentally are spontaneously ejected; however, a therapeutic endoscopy is required in 10 to 20% of cases and surgery in less than 1% of them.Objective: To analyze the characteristics of assisted patients due to foreign body ingestion in the Department of Emergency of Maciel Hospital and the design of protocols of action in the context of a multidisciplinary team. Results:Our series had 31 patients who came for consultation because of foreign body ingestion; 52% came from psychiatric care institutions, 42% were prisoners of state prison, and one case did not belong to any of the previous categories. About 27.5% of consultations occurred within the first 24 hours after ingestion, 24% of consultations in the Department of Emergency occurred after more than 1 week from ingestion, and the rest oscillated between both evolutionary times. Regarding the therapeutic behavior performed, in 12 cases it was decided to discharge the patient without active endoscopic conduct or surgery. A FGC was performed in 64% of cases in which the intake of the for...

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“…6 Foreign body ingestion can be asymptomatic or may present with severe abdominal pain and life threatening emergencies. 7 Early diagnosis and intervention is important to manage such conditions like intestinal perforation, fistula, ileus etc.…”

Section: Discussionmentioning

confidence: 99%

An unusual case of multiple intestinal perforations secondary to pica

et al. 2016

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Habitual ingestion of non-nutritive substances is the characteristic feature of a medical condition known as pica. It is usually associated with nutritional deficiency state, mental illness and at times with pregnancy. Most of the ingested foreign bodies pass through the digestive tract without causing complications however in about 1% cases, it can result in fatal complications such as intoxication, gastrointestinal perforation etc. Here we report a case of multiple intestinal perforations in a 28 year old patient secondary to his psychiatric illness Pica. The aim of this case report is to demonstrate its unusual presentation and to discuss the management of this rare case.

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Silent Perforations of the Stomach and Duodenum by Needles

Cited by 44 publications

References 17 publications

Needle Perforation of the Appendix

Needle Perforation of the Appendix

Ingesta de Cuerpos Extraños Estudio Prospectivo Observacional. Conducta Terapéutica y Resultados

An unusual case of multiple intestinal perforations secondary to pica

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