青少年乙状结肠异物长期嵌顿导致乙状结肠向肝区移位并穿孔一例

Delayed Sigmoid Colon Perforation and Hepatic Flexure Migration Caused by Retained Rectal Chopsticks in an Adolescent: A Case Report

摘要: 经肛门自行插入的异物在儿童和青少年中是较为罕见的，患儿通常表现为排便异常、腹痛、便血等症状，严重者可致肠穿孔，这些症状往往在异物插入后的短时间内出现，而异物在肠道内的长期嵌顿则更为罕见。患儿往往对此类事件羞于启口，这有赖于医生对患儿细致地观察和准确的影像学检查。我们报告一位13岁患儿经肛门自行插入异物，并于乙状结肠存留超过1年，造成乙状结肠移位至右上腹肝区附近，乙状结肠穿孔后表现为右上腹疼痛，经腹腔镜和结肠镜联合探查取出异物。

Abstract: Rectally self-inserted foreign bodies are rare in pediatric surgery. In adolescents, presentations often include tenesmus, abdominal pain, or hematochezia; intestinal perforation typically occurs soon after insertion. Shame and fear may delay disclosure. Careful clinical observation and imaging are essential. We report a 13yearold boy who selfinserted two wooden chopsticks via anus that remained in the sigmoid colon for over a year, displacing it to the right upper quadrant. Following recent physical exertion, he developed sigmoid perforation with right upper quadrant pain. The foreign bodies were successfully removed via colonoscopy combined with laparoscopy, and the patient recovered uneventfully.