Expulsion trans abdominale spontanée d’un corps étranger
Houcine Maghrebi, Zoubeir Bensafta
The Pan African Medical Journal. 2017;28:17. doi:10.11604/pamj.2017.28.17.13081

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Expulsion trans abdominale spontanée d’un corps étranger

Cite this: The Pan African Medical Journal. 2017;28:17. doi:10.11604/pamj.2017.28.17.13081

Received: 14/06/2017 - Accepted: 18/06/2017 - Published: 11/09/2017

Mots clés: Corps étranger, chirurgie, psychiatrie

© Houcine Maghrebi et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/28/17/full

Corresponding author: Maghrebi Houcine, Faculty of Medicine of Tunis, University of Tunis El Manar, Surgery Department la Rabta Hospital Tunis, Tunisia (houcine.maghrebi@gmail.com)


Expulsion trans abdominale spontanée d’un corps étranger

Spontaneous transabdominal expulsion of foreign body

Houcine Maghrebi1,&, Zoubeir Bensafta1

 

1Faculty of Medicine of Tunis, University of Tunis El Manar, Surgery Department la Rabta Hospital Tunis, Tunisia

 

 

&Auteur correspondant
Maghrebi Houcine, Faculty of Medicine of Tunis, University of Tunis El Manar, Surgery Department la Rabta Hospital Tunis, Tunisia

 

 

English abstract

Foreign body (FB) ingestion is a common medical emergency. It is much more rare in adults than in children and it occurs most often in predisposed people. We report the case of a 36-year old patient, treated in the psychiatry unit, admitted to the Emergency Department because of the ingestion of a 15 cm long iron wire which was spontaneously expelled through the abdominal wall at the level of the epigastrium. Clinical examination was normal with no peritoneal signs. (A) Abdominal CT scan (B) showed a linear foreign body expelled from the gastric antrum through a fistulous gastrocutaneous tract. The iron wire was removed under general anesthesia by gentle traction, extracting the tip remaining in the antrum leaving a gastrocutaneous fistula with no consequences. The postoperative course was uneventful. Foreign body ingestion is a frequent problem in current clinical practice. Nearly 80% of ingested foreign bodies spontaneously pass through the digestive tract, without any complication. 10-20% of these patients require endoscopic extraction and less than 1% a surgical intervention. Spontaneous expulsion through the abdominal wall is an exceptional event.


Key words: Foreign body, surgery, psychiatry



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L'ingestion d'un corps étranger (CE) est une urgence médicale courante. Chez l'adulte, cet accident est beaucoup plus rare que chez l'enfant et survient le plus souvent sur des terrains prédisposés. Nous rapportons le cas d’un patient âgé de 36 ans, suivi en psychiatrie, admis en urgence pour l’ingestion d’un fil de fer faisant 15 cm de long et qui a été spontanément expulsé à travers la paroi abdominale au niveau de l’épigastre.L’examen clinique était sans anomalie notamment pas de signe péritonéaux (A). La tomodensitométrie abdominale (B) avait mis en évidence un corps étranger linéaire extériorisé depuis l’antre gastrique à travers un trajet fistuleux gastro cutané. Le fil de fer a été retiré sous anesthésie générale par une traction douce extériorisant le bout restant dans l’antre laissant une fistule gastro cutané qui n’a rien ramené.Les suites opératoires étaient simples. L’ingestion de CE est un problème fréquent en pratique courante. Près de 80% des CE ingérés traversent spontanément la filière digestive sans aucune complication. Dix à 20% nécessitent la réalisation d’une extraction endoscopique et moins de 1% une intervention chirurgicale. L’expulsion spontanée à traves la paroi abdominale reste un événement exceptionnel.

Figure 1: A) vue préopératoire montrant le fil de fer extériorisé par la fistule; B) TDM pré-opératoire montrant le trajet du fil de fer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved