Nadir Bir Akut Karın Sebebi Yabancı Cisme Bağlı Perforasyon

Yabancı cisimlerin farkında olmadan yutulması, klinik pratikte sık rastlanılan bir durum olmasına rağmen; bunların ince bağırsak perforasyonuna neden olması nadiren görülür. Bu yazıda, kemikli-kırmızı etli bir yemek yenmesi sonrası gelişen, ince bağırsak perforasyon olgusu sunuldu. 63 yaşında erkek hasta, akut karın bulguları ile kırsal bölgeden acil servisimize sevk edilmişti. Acil serviste görülen hasta, şiddetli karın ağrısı, bulantı ve kusmadan şikayetçi idi. Karın periumblikal bölge ve sağ paraumblikal bölgede ve sağ  inguinal bölgede hiperemi hassasiyet, defans saptanmış olup bağırsak sesleri hipoaktif idi.  Hasta yakın zamanda parça etli bir yemek yeme öyküsü olduğunu ancak herhangi bir yabancı cisim yuttuğunun farkında olmadığını söyledi. Acil olarak ameliyata alındı. Hastada ne olduğu net anlaşılamayan bir yabancı cisime bağlı terminal ileumda perforasyon saptandı. Hastaya yabancı cisim çıkarılması ve primer ince barsak onarımı yapıldı. Aynı zamanda sağ inguinal bölgeden ağrılı yaklaşık 3cm’lik LAP eksizyonu yapıldı. Postoperatif altıncı günde hasta şifa ile taburcu edildi. 

A Rare Cause of Acute Abdomen Perforation Due to Foreign Body

Although it is common in clinical practice, inadvertent ingestion of foreign bodies rarely causes perforation of the small intestine. In this article, we present a case of small intestinal perforation following a meal with bony red meat. A 63-year-old male patient was referred to our emergency department from the countryside with acute abdominal symptoms. The patient, who was evaluated in the emergency department, had complaints of severe abdominal pain, nausea and vomiting. Hyperemia sensitivity and defense were detected in the periumbilical and right paraumbilical and right inguinal regions of the abdomen and intestinal sounds were hypoactive.  The patient reported that he had recently eaten a piece of meat, but was not aware that he had swallowed any foreign objects. He was operated immediately. Perforation at the terminal ileum resulting from an unknown foreign body was detected in the patient, which could not be identified clearly. Foreign body was removed and primary small intestine was repaired. Painful lymphadenopathy was concurrently excised at approximetly 3 cm from the right inguinal region. The patient was discharged on the sixth post-operative day.                           

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