НЕ ПОЛЬЗУЙТСЬ ЗУБОЧИСТКАМИ - ВИЛКОЙ БЕЗОПАСНЕЕ ... :-)

[Вячеслав Дмитриевич РЫНДИН]

Retroperitoneal colonic perforation "cannibalization" effect of a toothpick:

A 74-year-old female presented to the emergency department with fever and acute abdominal pain with diffuse guarding. Blood tests revealed a white cell count (WCC) of 12.000/mmc and C- Reactive Protein of 20mg/dL. A computerised tomographic (CT) scan with rectal contrast showed signs of a left-colonic perforation with a retroperitoneal fluid collection and retroperitoneal air bubbles. Perforated acute diverticulitis or a possible foreign body perforation was suspected, based on the CT images (Fig. 1-2).

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Laparoscopic emergent exploration was performed: the retroperitoneum was opened laparoscopically after incision of Toldt’s fascia and a retroperitoneal abscess was found. A left- colon perforation from a migrated toothpick was found. The abscess was evacuated, after microbiological sample for cultures and the toothpick was carefully removed laparoscopically. The perforation site was identified with methylene blue test and repaired laparoscopically.

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The patient was discharged on postoperative D11 after appropriate antibiotic treatment. Reconstruction of the CT-scan images allowed the correct pre-operative identification of the toothpick.

Arianna Birindelli M.D.(1), Gregorio Tugnoli M.D. PhD (1), Andrea Biscardi MD(1), Salomone Di Saverio M.D., FACS, FRCS(1)

[mikheev]

Круто!

[D-r Endo]

А вот и вилка)))

[Александр Петрушин]

Мне лично встречаться с подобным не приходилось. Перфорация рыбьей костью - это да, видел. Но в пубмеде довольно много информации о перфорации зубочистками http://www.ncbi.nlm.nih.gov/pubmed/?Db= ... erforation

[Вячеслав Дмитриевич РЫНДИН]