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A large Argentine tegu (Salvator merianae) presented with anorexia. Initial radiographs revealed a metallic foreign body in the stomach. The tegu vomited and became inactive two days later. A follow-up radiograph revealed the persistence of the foreign body in the same region. The foreign body was identified as a cluster of multiple magnets resembling neodymium magnets reported missing by the owner. An emergent laparotomy was performed due to gastrointestinal perforations caused by the multiple magnets. The surgical intervention revealed perforations in the walls of the stomach and small intestine and progressing acute peritonitis. Three magnets were extracted from the abdominal cavity and the tegu showed recovery. At 200 days postoperatively, the tegu continued to demonstrate good appetite and energy levels.
Asunto(s)
Cuerpos Extraños , Neodimio , Animales , Cuerpos Extraños/cirugía , Cuerpos Extraños/veterinaria , Imanes , Estómago/cirugía , Estómago/lesiones , Masculino , Perforación Intestinal/veterinaria , Perforación Intestinal/cirugía , Perforación Intestinal/etiologíaRESUMEN
Foreign body ingestion is a common condition in daily practice; fortunately, most cases do not require endoscopic or surgical treatment, as most foreign bodies pass through the intestine without injuring it. Although mainly seen in children, adults can also be affected, especially in accidental situations and suicide attempts. Therefore, the clinical history and the environment in which the event occurred are essential for a rapid diagnosis. This can be even more challenging as most adult patients are rarely aware of ingestion. Therefore, a high index of suspicion is necessary. Therapy will depend on the foreign body's size, shape and material; treatment should not be delayed if complications are detected. We present a case of a 34-year-old man who accidentally swallowed the mold of his teeth while undergoing a dental procedure. Subsequently, he presented with an intestinal obstruction that required surgery. Fortunately, he made a full recovery.
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Although the ingestion of plastics and other anthropogenic debris by seabirds is a global problem, few studies have employed standardized protocols to quantify and classify the debris ingested by seabirds in the Southwest Atlantic. We evaluated the ingestion of marine debris (items >0.1 mm) by 126 coastal and pelagic birds (19 species) along the coast of Espírito Santo, Eastern Brazil. Debris were found in 30% of birds examined (11 species). Particles <1 mm accounted for 35% of all debris items. Most ingested debris were plastics (97%). Ingestion of >0.1 g of plastic debris was recorded in five species: Atlantic yellow-nosed albatrosses (Thalassarche chlororhynchos), Cory's shearwaters (Calonectris borealis), Manx shearwaters (Puffinus puffinus), brown boobies (Sula leucogaster), and Magellanic penguins (Spheniscus magellanicus). Our findings suggest that the ingestion of marine debris, especially plastics, is a common problem for coastal and pelagic birds in tropical Southwest Atlantic waters.
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Plásticos , Spheniscidae , Animales , Brasil , Ingestión de Alimentos , Monitoreo del Ambiente , Contenido Digestivo/química , Residuos/análisisRESUMEN
Foreign body ingestion is a common condition in clinical practice, thankfully most of the cases do not require any surgery as most foreign bodies can pass through the bowel without injuring it. Treatment depends on the size and kind of foreign bodies. When complications arise, patients may require urgent medical attention. Self-harm by sharp foreign body ingestion is a rare event that must always be promptly treated and should always be prevented. Psychiatric patients and inmates are the most affected population. A high index of suspicion is required to treat this rare condition, which may be preventable if there is adequate mental and medical therapy along with close monitoring and family support. We present the case of a 31-year-old psychiatric patient. After prompt treatment, two razor blades were surgically removed from her intestines. She fully recovered and is doing well on follow-up controls.
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Introducción: La ingesta de cuerpos extraños (ICE) es frecuente en pediatría y puede llevar a complicaciones. Nuestro objetivo es revisar la experiencia de nuestro centro en el manejo de estos pacientes y proponer un protocolo de tratamiento. Material y Método: Estudio transversal retrospectivo, observacional y descriptivo, en el cual se revisaron los informes endoscópicos y fichas de pacientes con diagnóstico de ICE manejados por la Unidad de Endoscopia Pediátrica del Hospital Clínico Regional de Concepción entre enero de 2013 y junio de 2017 (53 meses), totalizando 40 casos. El registro y análisis de los datos se realizó con Microsoft® Excel 2016® para MacOS®. Resultados: El promedio de edad fue de 3,96 ± 3,24 años. La moda estadística fue de 2 años. A todos los pacientes se les realizó una endoscopia digestiva alta. El CE más frecuente fue la moneda (61,9%). En 6 casos (14,2%) fue una pila de botón. La retención de CE fue en tercio proximal del esófago (30,9%), el cuerpo gástrico (26,2%) y el tercio distal del esófago (14,2%), extrayéndose principalmente con pinza de cuerpo extraño (90,4%). El 57,5% evidenció alguna lesión relacionada a la ubicación del CE, siendo la más grave la producida por pila de botón. Conclusión: La ICE en niños es una entidad potencialmente peligrosa, por lo que se hace necesario disponer de una unidad de endoscopia pediátrica y protocolos de manejo para evitar complicaciones, sobre todo con objetos de alto riesgo.
Introduction: Foreign body ingestion (FBI) is common in pediatrics and can lead to complications. The aim of the present study is to review the experience of our center in the management of these patients and to propose a treatment protocol. Material and Method: Retrospective, observational and descriptive cross-sectional study, in which the endoscopic reports and records of patients diagnosed with IFB managed by the Pediatric Endoscopy Unit of the Regional Clinical Hospital of Concepción between January 2013 and June 2017 (53 months) were reviewed, with a total of 40 cases. Data recording and analysis was performed with Microsoft® Excel 2016® for MacOS®. Results: The average age was 3,96 ± 3,24 years. The statistical fashion was 2 years. All patients underwent a upper gastrointestinal endoscopy. The most frequent FB was the coin (61,9%). In 6 opportunities (14,2%) was a button batery. FB retention was in the proximal third of the esophagus (30,9%), the gastric body (26,2%) and the distal third of the esophagus (14,2%), being extracted mainly with foreign body clamp (90,4%). The 57,5% showed some injury related to the location of the FB, being the most serious the produced by button batery. Conclusion: FBI in children is a potentially dangerous entity, so it becomes necessary to have a pediatric endoscopy unit and treatment protocols to avoid complications, especially with high-risk objects.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Tracto Gastrointestinal Superior/diagnóstico por imagen , Cuerpos Extraños/cirugía , Cuerpos Extraños/diagnóstico , Algoritmos , Protocolos Clínicos , Estudios Retrospectivos , Endoscopía Gastrointestinal , Tracto Gastrointestinal Superior/lesiones , Esófago/diagnóstico por imagen , Cuerpos Extraños/complicacionesRESUMEN
Se presenta caso clínico de perforación intestinal por hueso de pollo tratado en el Hospital Central de Instituto de Previsión Social (IPS). Se trata de una mujer de 71 años de edad derivada de otro centro por cuadro de dolor abdominal de 24 hs de evolución, acompañándose de náuseas y vómitos. Con cirugía laparoscópica se halló una perforación del sigmoides por cuerpo extraño (hueso de pollo) que fue tratada con sutura primaria de la perforación y drenaje de cavidad por vía laparoscópica.
We present a clinical case of intestinal perforation for chicken bone treated at the Central Hospital of the Social Security Institute (IPS). The patient was a 71-year-old woman who was referred from another center with 24 hs abdominal pain, with nausea and vomiting. Laparoscopic surgery, a was done and sigmoid perforation was found by foreign body (chicken bone) that was treated with primary suture of the perforation and laparoscopic drainage of the cavity.
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A gastroenterologia sofreu uma verdadeira revolução com a introdução da endoscopia digestiva, principalmente a partir da década de 1960, com o desenvolvimento de novas técnicas e o aprimoramento do conhecimento científico. A endoscopia digestiva alta (EDA) ocupa um papel muito importante no arsenal diagnóstico e terapêutico na prática médica, em especial graças ao extraordinário avanço tecnológico ocorrido nos últimos anos. Atualmente, é possível avaliar e conduzir de maneira mais precisa as patologias gastrointestinais, entre elas as diversas formas de esofagites, gastrites, lesões pépticas, neoplásicas, vasculares e corpos estranhos, com melhor acurácia diagnóstica e menores complicações. A EDA é o principal e o mais importante método disponível na abordagem da hemorragia digestiva alta (HDA), tanto para o diagnóstico como para a terapêutica, com consequente influência no prognóstico dos pacientes. Além disso, exerce papel fundamental na avaliação e retirada dos corpos estranhos no trato digestivo, reduzindo de forma importante a morbimortalidade dos indivíduos acometidos por essa comorbidade. Com base nisso, o objetivo desse estudo é mostrar os resultados encontrados nos exames de EDA, realizados em âmbito ambulatorial ou emergencial, em um centro de treinamento em endoscopia digestiva.
Gastroenterology underwent a revolution with the introduction of endoscopy, mainly from the 1960, with the development of new techniques and the improvement of scientific knowledge. Upper endoscopy (EGD) occupies a very important role in diagnosis and therapeutics in medical practice, mainly due to the extraordinary technological advances of recent years. Currently, it is possible to evaluate and conduct more accurately the gastrointestinal disorders, including various forms of esophagitis, gastritis, peptic lesions, neoplastic, vascular, and foreign bodies, most accurate diagnoses and fewer complications. The EDA is the main and most important method available in the approach to upper gastrointestinal bleeding (UGIB), both for diagnosis and for therapy, with consequent influence on the prognosis of patients. Furthermore, plays a fundamental role in the evaluation and removal of foreign bodies in the digestive tract, greatly reducing the morbidity and mortality of individuals affected by this comorbidity. Based on this, the objective of this study is to show the results of EDA exams performed in outpatient or emergency context, a training center for endoscopy.
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Humanos , Masculino , Femenino , Lactante , Persona de Mediana Edad , Anciano de 80 o más Años , Endoscopía Gastrointestinal , Esofagitis , Cuerpos Extraños , Gastritis , Hemorragia GastrointestinalRESUMEN
Introducción. La ingestión de cuerpo extraño (CE) es frecuente observarla en la consulta pediátrica; aunque el mayor porcentaje son monedas, la ingestión de pilas de disco o botón son un problema serio. Objetivos: conocer las principales lesiones esofágicas ocasionadas por la ingesta de pilas de disco (IPD), así como la respuesta al manejo y su evolución. Métodos. En un estudio retrospectivo, donde se revisaron los expedientes de pacientes con diagnóstico de IPD de diciembre 1996 a 2007, se analizó: sexo, edad, síntomas, tiempo de evolución, hallazgos radiológicos y endoscópicos, manejo, complicaciones y secuelas. Resultados. Se encontraron 21 casos de IPD; predominó el sexo masculino en relación 4:1, con edades de 3 meses a 12 años. El síntoma principal fue sialorrea. El tiempo de evolución fue en promedio de 39.6 horas. En 14 pacientes la extracción del CE se realizó con laringoscopio tipo Jackson, con esofagoscopio rígido en 2 y con panendoscopio en 4, y en 1 se utilizó red de recuperación de Roth. La mayoría de los CE estaban alojados en el tercio superior de esófago. A la endoscopia se encontraron úlceras en 8 pacientes, necrosis en 6, úlcera y necrosis en 1, perforación parcial en 1, perforación con fístula traqueoesofágica en 2, y en 3 pacientes no hubo evidencia de lesión. Sólo 5 pacientes evolucionaron a estenosis esofágica, que se resolvió con dilataciones. Dos pacientes con perforación y fístula traqueoesofágica recibieron manejo quirúrgico, falleciendo uno de ellos. Otro paciente con perforación solicitó alta voluntaria. Conclusiones. La IPD es cada vez más frecuente, su extracción en el esófago debe ser urgente para evitar complicaciones graves como la estenosis y fístula traqueoesofágica.
Introduction. Foreign body ingestion is a common cause of consultation in the pediatric practice. Even though the most frequent ingested objects are coins, the button disk batteries are becoming a serious problem. Objectives: To describe the main esophageal lesions caused by the ingestion of button disk batteries, their response to treatment and clinical evolution. Methods. Files from patients admitted to our hospital with diagnosis of button disk battery ingestion between December 1996 to December 2007 were reviewed. We analyzed sex, age, symptoms, evolution time, radiological and endoscopical findings, management, complications and long term sequels. Results. We found 21 cases, male preponderance 4:1, age rank from 3 months to 12 years. Sialorrhea was the main symptom. Average time to treatment was 39.6 hours. Battery removal was accomplished with direct esophagoscopy using Jackson laryngoscope in 14 patients, rigid esophagoscope in 2 patients, and flexible esophagoscopy in 4. In most of the cases the battery was lodged in the proximal third of the esophagus. At endoscopic exploration, esophageal ulcers were found in 8 patients, necrosis in 6, ulcers and necrosis in 1, partial perforation in 1, perforation with traqueoesophageal fistula in 2, and no injury in 3 patients. Only 5 patients evolved to esophageal stenosis that resolved with dilatations. Two patients with perforation and traqueoesophageal fistula underwent surgical treatment, one of them died. Another patient with perforation was lost to follow up because of voluntary discharge. Conclusions. Button disk battery ingestion is becoming a more frequent event; removal from the esophagus should be an urgent procedure to avoid severe complications such as stenosis and traqueoesophageal fistula.