Small intestinal foreign body
Introduction
Small intestinal foreign body introduction Most of the foreign bodies in the small intestine are various items that are swallowed or deliberately swallowed. The former is more common in children, mental disorders or dentures, and the latter is more common in attempted suicides. The clinical symptoms are closely related to the length, size, shape, texture and weight of foreign bodies. Abdominal distension, constipation, and even vomiting may occur; foreign bodies may penetrate into the intestinal wall, causing abdominal pain, infection, and fever; foreign bodies may damage the intestinal mucosa, causing ulcers and bleeding. basic knowledge The proportion of illness: 0.003% Susceptible people: children Mode of infection: non-infectious Complications: intestinal obstruction acute peritonitis
Cause
Small intestinal foreign body cause
(1) Causes of the disease
1. Exogenous foreign body: Most foreign objects in the intestines are various items such as swallowing fish bones, fruit cores, buttons, coins, teeth, dentures, toothpicks, hairpins, keys, needles and nails; The service person is an attempted suicide or mentally ill person who intentionally swallows rings, chopsticks, toothbrush handles, toothpaste shells, keys, blades, knives, glass pieces, needles and nails. In addition, in order to evade customs inspections, drug smugglers also intend to Swallow bagged drugs.
2. Endogenous foreign body: There are mites, enteric stones entering the small intestine, gallstones into the duodenum and primary intestinal stones.
(two) pathogenesis
In general, most swallowed foreign bodies, if passed through the esophagus, will pass through the rest of the digestive tract without any obstacles, and will be excreted from the feces. A few may be embedded in the pylorus, duodenal jejunum or ileocecal At the flap, blunt foreign bodies can be expelled faster, and sharp foreign objects can pierce the intestinal wall to form a small abscess or granuloma. It has also been reported that after many years of ingestion of foreign bodies, abscesses or granulomas occur in the ileocecal area, and sharp foreign bodies are also present. It can lead to intestinal perforation, which often occurs at the appendix or at the Meckel's diverticulum.
Prevention
Intestinal foreign body prevention
Intestinal foreign bodies can be prevented. Children should be careful not to put items that may be swallowed beside them. Children should be educated to develop good hygiene habits, and not to put items other than food in the mouth. When adults are working, they should not include nails, needles, etc. in their mouths.
Complication
Small intestinal foreign body complications Complications, intestinal obstruction, acute peritonitis
Intestinal foreign bodies do not have any self-conscious symptoms, sometimes can cause intestinal obstruction, foreign body damage intestinal mucosa, can cause ulcers and bleeding; foreign body tearing the intestinal wall, can cause perforation and acute peritonitis.
Symptom
Small intestinal foreign body symptoms common symptoms constipation abdominal distension abdominal pain vomiting peritonitis
The clinical symptoms caused by foreign bodies in the small intestine are closely related to the length, shape, shape, texture and weight of foreign bodies. There are no symptoms in the intestines, and sometimes it can cause intestinal obstruction, foreign body obstruction, abdominal distension, constipation and even vomiting. Foreign body piercing or embedded in the intestinal wall can cause abdominal pain, infection and fever; foreign body damage intestinal mucosa, can cause ulcers and bleeding; foreign body tearing the intestinal wall can cause perforation and acute peritonitis; bagged bagged drugs are damaged, drug leakage Can cause symptoms of poisoning.
Examine
Intestinal examination of small intestine
X-ray (perspective and radiographic) has the value of diagnosis and positioning for opaque foreign objects. For example, it is a metal-containing foreign object that can be traced under X-rays. Small metal foreign objects can sometimes be seen in filming. Non-metallic foreign objects are required. Doing sputum angiography, or microscopic examination of the small intestine can confirm the diagnosis. As for the X-ray foreign body, some can also obtain the diagnostic intention. For example, the mites group can see the shape of the thick velvet in the umbilical cord in the X-ray film. Shadow, swallowed bagged drugs can show a smooth bag-shaped shadow with deeper density, endoscopy can be diagnosed, such as asymptomatic and indeed have a history of swallowing foreign bodies, you can carefully check the stool, usually in 3 ~ 5 Days can be discharged by themselves, do not use laxatives, such as no discharge after 1 week, and then for sputum angiography or enteroscopy.
Diagnosis
Diagnosis and identification of small intestinal foreign body
Ask in detail about the type and time of swallowing foreign body, whether it is intentional or unintentional swallowing, and what kind of symptoms, abdominal examination focus on whether there is flatulence, tenderness and block, pay attention to check the neuropsychiatric state.
After consultation with medical history and X-ray or radiography, the diagnosis is clear (including foreign body types), no differential diagnosis.
