BODIES OF THE DIGESTIVE TRACT

N.A.SERGEYEV, Y.A.ISAYEV, A.P.BARASHKOV

Tver State Medical Academy, Tver, RUSSIA

Introduction. Treatment of patients with foreign bodies of the digestive tract represents a complex task, associated with a variety of lesions, difficulty of diagnosis and safe removal of a number of foreign bodies. In connection with this, further study of theproblem is still urgent.

Materials and methods of study. We observed 30 patients with a various foreign bodies of the digestive tract. In 7 patients, they were located in the esophagus, and 4 - in the stomach, and 1 - in the jejunum, 4 - in the ileum, and 1 - in the hepatic flexure of the colon, 1 - in the sigmoid colon, and 1 - in the bowels (exact location was not determined). In 11 patients with suspected foreign body of the upper segment of the digestive tract, the supposed diagnosis was not confirmedduring emergent esophagogastroduodenoscopy. With the help of esophagogastroduodenoscopy the diagnose was set in the presence of a foreign body in the esophagus (7) and stomach (2). By means of survey radiography of the abdominal cavity foreign bodies were found in the stomach (2), ileum (1) and colon (1). In 6 patients an accurate diagnosis was set during an emergent laparotomy, performedfor supposed foreign body of the gastrointestinal tract (3), or peritonitis (3).

Results. Soft foreign bodies of the esophagus (pieces of meat) were removed by a working part of the endoscope into the stomach (6). Metallic foreign bodies of the esophagus (small nail) and stomach (supinator) are removed by gastroscopy (2). Fish bone was removed from the intestinal fistula during the bandage (1). During the emergency laparotomy (with perforations of the small intestine), foreign bodies (fish bone, toothpick and nail) were removed from the peritoneal cavity in 3 cases. During the agastrotomy (1) a teaspoon, enterotomy (2) - a tuft of grass and a handle of a tablespoon, colotomy (1) –a sewing needle and a handleof a tablespoon were removed. In 1 patient (a foreign body was not found), the operation was finished by suturing of perforated holes of the sigmoid colon. In 2 patients, natural “outlet” of sewing needle and a nail from the stomach was observed.

Conclusion.Dynamic observation of victims was very important along with the endoscopic and radiological methods of diagnosis. In the treatment, the preference should be given to urgent endoscopic operations, and in case of their impossibility or failure to urgent interventions.

Date: 2014-12-28; view: 866