鸡骨致下消化道大出血1例

A case of lower gastrointestinal hemorrhage caused by chicken bone

患者,男,19岁,因便血1d,腹痛1h入院。入院前1d无明显诱因出现棕红色血便40余次,量约1 500ml,无腹痛,无恶心、呕吐。入院前1h出现脐周、上腹部间断性绞痛,无恶心、呕吐,排暗红色血水便。入院后给予止血、抗感染治疗1d,仍持续排暗红色血水便,量约1 100ml。即急诊行结肠镜检查：整个结肠均见有大量新鲜不凝血,吸引冲洗后未见活动出血灶,进入回肠末端,见小肠黏膜弥漫性亚蒂小息肉,表面光滑,未见新鲜血,退镜至回 盲部用清水冲洗，见新鲜血液自阑尾开口处流出，并见阑尾开口处卡有一褐色异物，用异物网篮将其取出，证实为鸡颈椎骨，局部喷洒止血药水冲洗见黏膜破损。退镜再次观察各段肠腔黏膜光滑，色泽正常，未见活动性出血点。继续抗炎、止血治疗。第2天排少许棕红色血便，第3天后未再便血，住院10d治愈出院。

Summary This paper reported a case ol tower gastrointestinal hemorrhage caused by chlclcen bone. l ms pa- tient was 19 years old. He suffered hematochezia and intermittent abdominal pain. After treatment of stopping, bleeding and anti-infection, the symptoms of hematochezia was unimproved. We found fresh blood pouring from the outset of appendix by colonoscope. After taking out of the foreign body and sprinkling hemostatic on bloody intesti- nal mucosa by colonoscope, the symptoms of hematochezia were improved and finally were completely cured.