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首页> 外文期刊>World Journal of Surgical Oncology >Colonic perforation resulting from ingested chicken bone revealing previously undiagnosed colonic adenocarcinoma: report of a case and review of literature
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Colonic perforation resulting from ingested chicken bone revealing previously undiagnosed colonic adenocarcinoma: report of a case and review of literature

机译：食入鸡骨头引起的结肠穿孔揭示了先前未被诊断的结肠腺癌：一例病例报告并文献复习

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An 86 year old male with a four-day history of nonspecific gastrointestinal symptoms was found on colonoscopy to have evidence of sigmoid colon obstruction and possible perforation. Emergent operative exploration revealed diffuse peritonitis, sigmoid perforation, adjacent dense adhesions, and a foreign body protruding through the perforated area. Pathologic examination showed the foreign body to be a sliver of bone consistent with chicken bone and the sigmoid subacute perforation to be associated distally with a circumferential ulcerated obstructing mass, microscopically seen to be transmurally infiltrating adenocarcinoma, signet-ring cell type. There was extensive acute and organizing peritonitis, 100% Escherichia coli was cultured from peritoneal fluid, and the patient died two days postoperatively with sepsis and hypotension. This appears to be the fifth reported case of colonic perforation resulting from foreign body perforation due to previously undiagnosed adenocarcinoma. The four previously reported cases were all deeply invasive adenocarcinoma of sigmoid colon, and the foreign bodies included three chicken/poultry bones and a metallic staple. These five cases are highly unusual examples of a potentially lethal malignant neoplasm being clinically revealed by a usually (but not always) innocuous event, the ingestion of a small foreign body.
机译：在结肠镜检查中发现一名86岁男性，有四天的非特异性胃肠道症状史，有乙状结肠梗阻和可能穿孔的证据。紧急手术探查发现弥漫性腹膜炎，乙状结肠穿孔，相邻的密集粘连和异物从穿孔区域突出。病理检查显示异物为与鸡骨一致的骨条，乙状结肠亚急性穿孔在远端与周围溃疡性阻塞性肿块相关，在显微镜下可见其为透壁浸润性腺癌，图环细胞类型。广泛性急性和组织性腹膜炎，从腹膜液培养出100％的大肠杆菌，患者术后两天死亡，败血症和低血压。这似乎是第五例报道的结肠穿孔的病例，该结肠穿孔是由于先前未诊断出的腺癌导致的异物穿孔所致。先前报道的四例均为乙状结肠深浸润性腺癌，异物包括三只鸡/禽类骨头和金属钉书钉。这五例是极不寻常的例子，通常（但不总是）无害事件（摄入少量异物）在临床上揭示出潜在致命的恶性肿瘤。

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