Text/Yangcheng Evening News all-media reporter Yu Yanhong Correspondent Wang Hui Bai Tian
Photo/Courtesy of the hospital
"Doctor, I accidentally swallowed a comb, can you quickly help me get it out?!" On January 3, the Emergency Department of the Third Affiliated Hospital of Guangzhou Medical University received a very anxious female patient. It turned out that the night before, the woman had swallowed a plastic long comb by mistake because of the vomiting after drinking.
After understanding the relevant situation, the Endoscopy Center of the Department of Gastroenterology of the Third Hospital of Guangdong Medical College quickly performed gastroscopic surgery on her and took out a plastic comb with a length of 17 cm and a width of about 3 cm from her stomach! Fortunately, the comb did not cause stomach damage to the patient, and the patient was successfully discharged from the hospital on the same day.
After drinking, a long comb actually slid from the esophagus into the stomach
On the evening of January 2, taking advantage of the New Year's Day holiday, Ms. Li (pseudonym) and relatives and friends went out to play in the suburbs, it was inevitable to have a few drinks when eating supper at night, and when she returned to the residence, due to the discomfort after drinking, she wanted to induce vomiting, so she picked up the hotel's disposable comb as a tongue depressor to induce vomiting, but unexpectedly not only did not spit it out, but accidentally swallowed the comb!
Ms. Li rushed to the nearby hospital for treatment, because the comb was plastic, it could not be developed under CT examination, and it was the early morning of the holiday, and the local hospital could not carry out endoscopic operations, so she waited until the next morning, accompanied by her family, to the emergency department of the Third Hospital of Guangdong Medical University.
Dr. Song Lei, who received the patient, underwent a plain abdominal examination for the patient, but was still unable to determine the specific location of the plastic comb in Ms. Li's body. And the comb is large and cannot be discharged on its own, the emergency department immediately contacted the hospital's gastroenterology endoscopy center and tried to remove it through gastroscopy.
Doctor's hand-drawn picture of the state of the comb in the stomach (left) and the surgical procedure (right)
Endoscopic surgery removes a 17 cm long comb
"Because the comb that the patient swallowed by mistake is relatively large, and the time of swallowing is not long from the time of medical treatment, we preliminarily judged that the probability (of the comb) is in the stomach." The stomach is in the empty state, the longest diameter from the bottom of the stomach to the pylorus is about 10 cm, a comb is across the stomach, CT can not be developed, only through the gastroscope to detect the situation and try to take it out. "Doctor Qingqing of the Department of Gastroenterology of the Third Hospital of Guangdong Medical College introduced.
Because the comb has teeth, if not handled properly, it may cause perforation of the ball of the duodenum, and at the same time, when the comb is removed, the gastric cardia is narrowed, which is easy to cause cardia tearing, and when the comb is finally removed from the larynx, it is necessary to expand the curvature of the stenosis, otherwise it may also cause mucosal damage and bleeding, which will cause aspiration and suffocation in severe cases. Therefore, surgery has certain difficulties and risks.
After full communication with the patient, with the close cooperation of the operating room and anesthesiologists, Dr. Qingqing and Hu Zongyi, the head nurse of the Department of Gastroenterology and Internal Economic Center, immediately performed general anesthesia gastroscopic foreign body retrieval surgery for the patient.
The gastroenterologist of the Third Hospital of Guangdong Medical University performs gastroscopic foreign body retrieval surgery for patients
During the operation, the mirror entered the stomach and continued to inflate, enlarging the gastric cavity, fortunately the edge of the comb was smooth, no obvious bleeding was found in the gastric mucosa, and no perforation occurred in the ball of the duodenum.
During the operation, the doctor uses foreign body forceps to pull the comb to obtain a good position, and uses a snare to cover the top of the comb, so that the comb remains in a vertical position with the cardia plane, continuously inflates the esophagus, waits for the esophagus to expand, and then gently and slowly brings out the comb.
Several doctors worked closely together to smoothly remove the comb in only ten minutes, and the size of the comb was 17cm*3cm measured after the operation. After giving the patient anti-infective therapy and gastric drug treatment after the operation, the patient was discharged from the hospital on the same day.
The comb is visible during surgery and removed after surgery
Doctors remind: If you swallow a foreign body by mistake, you must seek medical attention in time
Dr. Qingqing of the Department of Gastroenterology introduced: "Foreign bodies in the digestive tract are more common, especially in children, but foreign bodies with such a long comb are indeed rare in the clinic. Hu Zongyi, the director of the endoscopy center of the hospital, introduced that the gastroenterology endoscopy center of the hospital has also received foreign bodies such as accidental swallowing of blades, screws, rings, toothpicks and so on.
"For patients who swallow foreign bodies by mistake, it is necessary to judge the types and size of the foreign bodies swallowed by the patient to judge the mode of treatment, some small foreign bodies can eat more leeks, cabbage and other vegetables to help themselves excrete, while large foreign bodies or sharp foreign bodies generally need to be removed surgically." Dr. Song Lei of the emergency department said.
Dr. Qingqing reminds that if you accidentally swallow a foreign body, do not try to swallow the foreign body hard through "folk methods" such as drinking vinegar and swallowing rice, and must seek medical treatment in time to judge and determine the treatment method by the doctor.
In particular, sharp foreign bodies such as toothpicks and fish bones may move in place, often easily piercing the walls of the esophagus, stomach and even intestines, and causing local inflammation, damage and further spread of inflammation can cause serious comorbidities such as mediastinitis, lung infection or esophageal tracheal fistula, which will be life-threatening. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Cui Wencan