BACKGROUND Acute abdominal pain is one of the most common gastrointestinal symptoms.The etiology of acute abdomen can be challenging for gastroenterologists to establish.Cecal foreign body is a rare cause of cecal per...BACKGROUND Acute abdominal pain is one of the most common gastrointestinal symptoms.The etiology of acute abdomen can be challenging for gastroenterologists to establish.Cecal foreign body is a rare cause of cecal perforation.CASE SUMMARY We report a 35-year-old male from China who initially exhibited symptoms suggestive of acute appendicitis.However,during a minimally invasive colonoscopy procedure,the authors found that a wooden toothpick caused the perforation.The patient presented to our emergency department with a 2 days history of right lower abdominal pain and low grade fever.The patient was in good health and had eaten fish 2 days earlier.Physical examination revealed mild pain with positive rebound tenderness in the right lower abdomen.However,computed tomography of the abdomen confirmed a strip of high-density shadows protruding beyond the intestinal cavity outline,with a small amount of peritoneal seepage in the ileocecal area.Combined with the medical history,the possibility of foreign body perforation by a fishbone and peripheral peritonitis were considered.However,the high-density shadow was identified as a wooden toothpick,which was removed via a minimally invasive procedure using a foreign body forceps under colonoscopy.The patient's condition improved significantly within 5 days after treatment.CONCLUSION We emphasize the importance of a detailed patient history,accurate diagnosis and proper treatment in patients with acute abdomen.展开更多
Foreign bodies in the colon are encountered with increasing frequency, but only sporadic reports concerning their management have appeared in the literature. While most ingested foreign bodies usually pass through the...Foreign bodies in the colon are encountered with increasing frequency, but only sporadic reports concerning their management have appeared in the literature. While most ingested foreign bodies usually pass through the gastrointestinal tract uneventfully, sharp foreign bodies such as toothpicks infrequently cause intestinal perforation and may even result in death. We report our experience with a patient with a sigmoid colon pseudodiverticulum formation, a complication of accidental ingestion of a toothpick that was diagnosed and successfully managed colonoscopically.展开更多
We reported a 55-year-old man who suffered from chest pain and dyspnea on exertion for two weeks associated with night sweating, general malaise, poor appetite, and body weight loss. Physical examination revealed fric...We reported a 55-year-old man who suffered from chest pain and dyspnea on exertion for two weeks associated with night sweating, general malaise, poor appetite, and body weight loss. Physical examination revealed friction rub with distant heart sound, bilateral clear breathing sound, no abdomen tenderness, and normal bowel sound. Subsequent chest X-ray revealed cardiomegaly and cardiac echo showed massive pericardial and pleural effusion with normal left ventricular function. Constrictive pericarditis was diagnosed based on clinical information. Tuberculosis (TB), malignancy, autoimmune disease, infection, hypothyroidism, and idiopathic could be the causes but excluded by further study. High-resolution lung CT scan after reconstruction revealed a moderate amount pericardial effusion with possible superimposed infection. Thickness of pericardium and left lobe liver abscess were found. A straight tubular structure about 6 cm in length transverses the lateral segment of liver to pericardial space and unknown foreign body was suspected. Laparotomy was performed, 6.5 cm toothpick was found through the liver into pericardium. Post-operative course was uneventful and he discharged one week later. The patient could not remember swallowing the toothpick before. He had no chest pain and dyspnea on exertion during a 6-mo follow-up period.展开更多
The prevalence of periodontal disease among pregnant women increases with gestational age. Therefore, oral health education in the early stage of pregnancy should prevent periodontal disease and decrease the risk of a...The prevalence of periodontal disease among pregnant women increases with gestational age. Therefore, oral health education in the early stage of pregnancy should prevent periodontal disease and decrease the risk of an adverse pregnancy outcome such as preterm delivery and low birth weight. However, there has been no study on oral health care intervention for prevention of periodontal disease during pregnancy. The purpose of this study was to examine the efficiency of an oral health education program on periodontal disease among Japanese low-risk pregnant women. A total of 207 pregnant women before 20 weeks of gestation were recruited. The first 131 of them were assigned to the control group and the remaining 76 to the experimental group. The experiment participants received an oral health education program including the toothpick brushing method in their early stage of pregnancy. Improvement of the self-assessment score of periodontal symptoms was used as a binary outcome variable. A logistic regression analysis indicated that the intervention (OR = 3.83) and proficiency of the toothpick brushing method (OR = 24.93) were statistically significant predictors of the outcome in the late stage of pregnancy. The positive outcome appeared after practice of the toothpick method brushing for 20 or more weeks, and was associated with the decrease in the log-transformed proportion of the count of Candida species in salivary microbiota (p = 0.026).展开更多
文摘BACKGROUND Acute abdominal pain is one of the most common gastrointestinal symptoms.The etiology of acute abdomen can be challenging for gastroenterologists to establish.Cecal foreign body is a rare cause of cecal perforation.CASE SUMMARY We report a 35-year-old male from China who initially exhibited symptoms suggestive of acute appendicitis.However,during a minimally invasive colonoscopy procedure,the authors found that a wooden toothpick caused the perforation.The patient presented to our emergency department with a 2 days history of right lower abdominal pain and low grade fever.The patient was in good health and had eaten fish 2 days earlier.Physical examination revealed mild pain with positive rebound tenderness in the right lower abdomen.However,computed tomography of the abdomen confirmed a strip of high-density shadows protruding beyond the intestinal cavity outline,with a small amount of peritoneal seepage in the ileocecal area.Combined with the medical history,the possibility of foreign body perforation by a fishbone and peripheral peritonitis were considered.However,the high-density shadow was identified as a wooden toothpick,which was removed via a minimally invasive procedure using a foreign body forceps under colonoscopy.The patient's condition improved significantly within 5 days after treatment.CONCLUSION We emphasize the importance of a detailed patient history,accurate diagnosis and proper treatment in patients with acute abdomen.
文摘Foreign bodies in the colon are encountered with increasing frequency, but only sporadic reports concerning their management have appeared in the literature. While most ingested foreign bodies usually pass through the gastrointestinal tract uneventfully, sharp foreign bodies such as toothpicks infrequently cause intestinal perforation and may even result in death. We report our experience with a patient with a sigmoid colon pseudodiverticulum formation, a complication of accidental ingestion of a toothpick that was diagnosed and successfully managed colonoscopically.
文摘We reported a 55-year-old man who suffered from chest pain and dyspnea on exertion for two weeks associated with night sweating, general malaise, poor appetite, and body weight loss. Physical examination revealed friction rub with distant heart sound, bilateral clear breathing sound, no abdomen tenderness, and normal bowel sound. Subsequent chest X-ray revealed cardiomegaly and cardiac echo showed massive pericardial and pleural effusion with normal left ventricular function. Constrictive pericarditis was diagnosed based on clinical information. Tuberculosis (TB), malignancy, autoimmune disease, infection, hypothyroidism, and idiopathic could be the causes but excluded by further study. High-resolution lung CT scan after reconstruction revealed a moderate amount pericardial effusion with possible superimposed infection. Thickness of pericardium and left lobe liver abscess were found. A straight tubular structure about 6 cm in length transverses the lateral segment of liver to pericardial space and unknown foreign body was suspected. Laparotomy was performed, 6.5 cm toothpick was found through the liver into pericardium. Post-operative course was uneventful and he discharged one week later. The patient could not remember swallowing the toothpick before. He had no chest pain and dyspnea on exertion during a 6-mo follow-up period.
文摘The prevalence of periodontal disease among pregnant women increases with gestational age. Therefore, oral health education in the early stage of pregnancy should prevent periodontal disease and decrease the risk of an adverse pregnancy outcome such as preterm delivery and low birth weight. However, there has been no study on oral health care intervention for prevention of periodontal disease during pregnancy. The purpose of this study was to examine the efficiency of an oral health education program on periodontal disease among Japanese low-risk pregnant women. A total of 207 pregnant women before 20 weeks of gestation were recruited. The first 131 of them were assigned to the control group and the remaining 76 to the experimental group. The experiment participants received an oral health education program including the toothpick brushing method in their early stage of pregnancy. Improvement of the self-assessment score of periodontal symptoms was used as a binary outcome variable. A logistic regression analysis indicated that the intervention (OR = 3.83) and proficiency of the toothpick brushing method (OR = 24.93) were statistically significant predictors of the outcome in the late stage of pregnancy. The positive outcome appeared after practice of the toothpick method brushing for 20 or more weeks, and was associated with the decrease in the log-transformed proportion of the count of Candida species in salivary microbiota (p = 0.026).
