Perforación intestinal por espina de pescado, revisión de la literatura científica y presentación de dos casos
Palabras clave:
perforación intestinal, cuerpos extraños, diagnóstico, diagnóstico por imagen, complicacionesResumen
La presentación clínica de las perforaciones intestinales secundarias a la ingestión involuntaria de espinas de pescado suele ser inespecífica, lo que hace difícil su diagnóstico. Por tratarse de un cuadro clínico relativamente frecuente y potencialmente fatal, es necesario establecer un diagnóstico temprano y una terapia quirúrgica inmediata.
En este artículo se hace una revisión de la literatura y se presentan dos casos clínicos de perforación intestinal por espina de pescado atendidos en el Hospital Universitario San Ignacio.
El propósito de este trabajo es revisar la literatura y reportar dos casos tratados en el Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
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Referencias bibliográficas
1. Chiu JJ, Chen TL, Zhan YL. Perforation of the transverse colon by a fish bone: Acase report. J Emerg Med. 2009;36:345-7.
https://doi.org/10.1016/j.jemermed.2007.11.007
2. Pinero A, Fernández JA, Carrasco M, Riquelme J, Parrila P. Intes- tinal perforation by foreign bodies. Eur J Surg. 2000;166:307-9.
https://doi.org/10.1080/110241500750009140
3. Drakonaki E, Chatzioannou M, Spiridakis K, Panagiotakis G. Acute abdomen caused by a small bowel perforation due to a clinically unsuspected fish bone. Diagn Interv Radiol. 2011;17:160-2.
https://doi.org/10.4261/1305-3825.DIR.3236-09.1
4. Coulier B, Tancredi MH, Ramboux A. Spiral CT and multidetec- tor-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies. Eur Radiol. 2004;14:1918-25.
https://doi.org/10.1007/s00330-004-2430-1
5. Singh RP, Gardner JA. Perforation of the sigmoid colon by swallowed chicken bone: Case reports and review of literature. Int Surg. 1981;66:181-3.
6. Goh BK, Chow PK, Quah HM, Ong HS, Eu KW, Ooi LL, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg. 2006;30:372-7.
https://doi.org/10.1007/s00268-005-0490-2
7. Société Medicale d'Emulation: Phlebitis from a fish-bone, which passed through the stomach, and penetrated the mesenteric vein. Prov Med Surg J. 1841;3:77.
https://doi.org/10.1136/bmj.s1-3.4.77
8. Al-Muhanna A, Abu-Chra KA, Dashti H, Behbehani A, al- Naqeeb N. Thyroid lobectomy for removal of a fish bone. J Laryngol Otol. 1990;104:511-2.
https://doi.org/10.1017/S0022215100113039
9. Bendet E. Thyroid lobectomy for removal of a fish bone. J Laryngol Otol. 1991;105:157.
https://doi.org/10.1017/S0022215100115233
10. Coret A, Heyman Z, Bendet E, Amitai M, Itzchak I, Kronberg J. Thyroid abscess resulting from transesophageal migration of a fish bone: Ultrasound appearance. J Clin Ultrasound. 1993;21:152-4.
https://doi.org/10.1002/jcu.1870210215
11. Foo TH. Migratory fish bone in the thyroid gland. Singapore Med J. 1993;34:142-4.
12. Sharland MG, McCaughan BC. Perforation of the esophagus by a fish bone leading to cardiac tamponade. Ann Thorac Surg. 1993;56:969-71.
https://doi.org/10.1016/0003-4975(93)90368-R
13. Remes-Troche J, Salazar L, Peña E. Extracción endoscópica de espina de pescado en el esófago cervical. Rev Gastroenterol Mex. 2010;75:326-7.
14. González M, Gómez M, Otero W. Cuerpos extraños en esófago. Rev Col Gastroenterol.2006;21:150-161.
15. Selivanov V, Sheldon GF, Cello JP, Crass RA. Management of foreign body ingestion. Ann Surg. 1984;199:187-91.
https://doi.org/10.1097/00000658-198402000-00010
16. Velitchkov NG, Grigorov GI, Losanoff JE, Kjossev KT.Ingested foreign bodies of the gastrointestinal tract: Retrospective analysis of 542 cases. World J Surg. 1996;20:1001-5.
https://doi.org/10.1007/s002689900152
17. Theodoropoulou A, Roussomoustakaki M, Michalodimitrakis MN, Kanaki C, Kouroumalis EA. Fatal hepatic abscess caused by a fish bone. Lancet. 2002;359:977.
https://doi.org/10.1016/S0140-6736(02)07999-0
18. Goh BK, Jeyaraj PR, Chan HS, Ong HS, Agasthian T, Chang KT, et al. A case of fish bone perforation of the stomach mi- micking a locally advanced pancreatic carcinoma. Dig Dis Sci. 2004;49:1935-7.
https://doi.org/10.1007/s10620-004-9595-y
19. Yeung KW, Chang MS, Hsiao CP, Huang JF. CT evaluation of gastrointestinal tract perforation. Clin Imaging. 2004;28:329-33.
https://doi.org/10.1016/S0899-7071(03)00204-3
20. Hainaux B, Agneessens E, Bertinotti R, De Maertelaer V, Rub- esova E, Capelluto E, et al. Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR Am J Roentgenol. 2006;187:1179-83.
https://doi.org/10.2214/AJR.05.1179
21. Furukawa A, Sakoda M, Yamasaki M, Kono N, Tanaka T, Nitta N, et al. Gastrointestinal tract perforation: CT diagnosis of presence, site, and cause. Abdom Imaging. 2005;30:524-34.
https://doi.org/10.1007/s00261-004-0289-x
22. Imuta M, Awai K, Nakayama Y, Murata Y, Asao C, Matsukawa T, et al. Multidetector CT findings suggesting a perforation site in the gastrointestinal tract: Analysis in surgically confirmed 155 patients. Radiat Med. 2007;25:113-8.
https://doi.org/10.1007/s11604-006-0112-4
23. Maniatis V, Chryssikopoulos H, Roussakis A, Kalamara C, Kavadias S, Papadopoulos A, et al. Perforation of the alimentary tract: Evaluation with computed tomography. Abdom Imaging. 2000;25:373-9.
https://doi.org/10.1007/s002610000022
24. Ongolo-Zogo P, Borson O, García P, Gruner L, Valette PJ. Acute gastroduodenal peptic ulcer perforation: Contrast-enhanced and thin-section spiral CT findings in 10 patients. Abdom Imaging. 1999;24:329-32.
https://doi.org/10.1007/s002619900509
25. Fultz PJ, Skucas J, Weiss SL. CT in upper gastrointestinal tract perforations secondary to peptic ulcer disease. Gastrointest Radiol. 1992;17:5-8.
https://doi.org/10.1007/BF01888496
26. Stapakis JC, Thickman D. Diagnosis of pneumoperitoneum: Abdominal CT Vs. upright chest film. J Comput Assist Tomogr. 1992;16:713-6.
https://doi.org/10.1097/00004728-199209000-00008
27. Kwok KY, Wing TS, Chun NT, Laparoscopic versus open appendectomy for complicated appendicitis. J Am Coll Surg. 2007;205:60-5.
https://doi.org/10.1016/j.jamcollsurg.2007.03.017
28. Ordoñez CA, Puyana JC. Management of peritonitis in the critically ill patient. Surg Clin North Am. 2006;86:1323-49.
https://doi.org/10.1016/j.suc.2006.09.006
29. Mai V, Morris JG. Colonic bacterial flora: Changing understan- dings in the molecular age. J Nutr. 2004;134:459-64.
https://doi.org/10.1093/jn/134.2.459
30. Condon RE. Microbiology of intra-abdominal infection and contamination. Eur J Surg Suppl. 1996;576:9-12.
https://doi.org/10.2165/00128413-199610670-00022
31. Chong AJ, Dellinger EP. Current treatment of intraabdominal infections. Surg Technol Int. 2005;14:29-33.
32. FredericB, Karine P, CarolineM. Emergency laparoscopic management of perforated sigmoid diverticulitis: A promi- sing alternative to more radical procedures. J Am Coll Surg. 2008;206:654-7.
https://doi.org/10.1016/j.jamcollsurg.2007.11.018
33. Shukla PJ, Maharaj R, Fingerhut A. Ergonomics and technical aspects of minimal access surgery in acute surgery. Eur J Trauma Emerg Surg. 2010;36:3-9.
https://doi.org/10.1007/s00068-010-9226-6
34. Myers E, Hurley M, O'Sullivan GC. Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg. 2008;95:97-101.
https://doi.org/10.1002/bjs.6024
35. Martin RF, Rossi RL. The acute abdomen and overview and algorithms. Surg Clin North Am. 1997;77:1227-43.
https://doi.org/10.1016/S0039-6109(05)70615-0
36. de Graff JS, van Goor H, Bleichrodt RP. Primary small bowel anastomosis in generalized peritonitis. Eur J Surg. 1996;162:55-8.
37. Barker DE, Green JM, Maxwell RA, Smith PW, Mejia VA, Dart BW, et al. Experience with vacuum-pack temporary abdominal wound closure in 258 trauma and general and vascular surgical patients. J Am Coll Surg. 2007;204:784-93
https://doi.org/10.1016/j.jamcollsurg.2006.12.039
38. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving sepsis and septic shock. Intensive Care Med. 2004;30:536-55.
https://doi.org/10.1007/s00134-004-2210-z
https://doi.org/10.1016/j.jemermed.2007.11.007
2. Pinero A, Fernández JA, Carrasco M, Riquelme J, Parrila P. Intes- tinal perforation by foreign bodies. Eur J Surg. 2000;166:307-9.
https://doi.org/10.1080/110241500750009140
3. Drakonaki E, Chatzioannou M, Spiridakis K, Panagiotakis G. Acute abdomen caused by a small bowel perforation due to a clinically unsuspected fish bone. Diagn Interv Radiol. 2011;17:160-2.
https://doi.org/10.4261/1305-3825.DIR.3236-09.1
4. Coulier B, Tancredi MH, Ramboux A. Spiral CT and multidetec- tor-row CT diagnosis of perforation of the small intestine caused by ingested foreign bodies. Eur Radiol. 2004;14:1918-25.
https://doi.org/10.1007/s00330-004-2430-1
5. Singh RP, Gardner JA. Perforation of the sigmoid colon by swallowed chicken bone: Case reports and review of literature. Int Surg. 1981;66:181-3.
6. Goh BK, Chow PK, Quah HM, Ong HS, Eu KW, Ooi LL, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg. 2006;30:372-7.
https://doi.org/10.1007/s00268-005-0490-2
7. Société Medicale d'Emulation: Phlebitis from a fish-bone, which passed through the stomach, and penetrated the mesenteric vein. Prov Med Surg J. 1841;3:77.
https://doi.org/10.1136/bmj.s1-3.4.77
8. Al-Muhanna A, Abu-Chra KA, Dashti H, Behbehani A, al- Naqeeb N. Thyroid lobectomy for removal of a fish bone. J Laryngol Otol. 1990;104:511-2.
https://doi.org/10.1017/S0022215100113039
9. Bendet E. Thyroid lobectomy for removal of a fish bone. J Laryngol Otol. 1991;105:157.
https://doi.org/10.1017/S0022215100115233
10. Coret A, Heyman Z, Bendet E, Amitai M, Itzchak I, Kronberg J. Thyroid abscess resulting from transesophageal migration of a fish bone: Ultrasound appearance. J Clin Ultrasound. 1993;21:152-4.
https://doi.org/10.1002/jcu.1870210215
11. Foo TH. Migratory fish bone in the thyroid gland. Singapore Med J. 1993;34:142-4.
12. Sharland MG, McCaughan BC. Perforation of the esophagus by a fish bone leading to cardiac tamponade. Ann Thorac Surg. 1993;56:969-71.
https://doi.org/10.1016/0003-4975(93)90368-R
13. Remes-Troche J, Salazar L, Peña E. Extracción endoscópica de espina de pescado en el esófago cervical. Rev Gastroenterol Mex. 2010;75:326-7.
14. González M, Gómez M, Otero W. Cuerpos extraños en esófago. Rev Col Gastroenterol.2006;21:150-161.
15. Selivanov V, Sheldon GF, Cello JP, Crass RA. Management of foreign body ingestion. Ann Surg. 1984;199:187-91.
https://doi.org/10.1097/00000658-198402000-00010
16. Velitchkov NG, Grigorov GI, Losanoff JE, Kjossev KT.Ingested foreign bodies of the gastrointestinal tract: Retrospective analysis of 542 cases. World J Surg. 1996;20:1001-5.
https://doi.org/10.1007/s002689900152
17. Theodoropoulou A, Roussomoustakaki M, Michalodimitrakis MN, Kanaki C, Kouroumalis EA. Fatal hepatic abscess caused by a fish bone. Lancet. 2002;359:977.
https://doi.org/10.1016/S0140-6736(02)07999-0
18. Goh BK, Jeyaraj PR, Chan HS, Ong HS, Agasthian T, Chang KT, et al. A case of fish bone perforation of the stomach mi- micking a locally advanced pancreatic carcinoma. Dig Dis Sci. 2004;49:1935-7.
https://doi.org/10.1007/s10620-004-9595-y
19. Yeung KW, Chang MS, Hsiao CP, Huang JF. CT evaluation of gastrointestinal tract perforation. Clin Imaging. 2004;28:329-33.
https://doi.org/10.1016/S0899-7071(03)00204-3
20. Hainaux B, Agneessens E, Bertinotti R, De Maertelaer V, Rub- esova E, Capelluto E, et al. Accuracy of MDCT in predicting site of gastrointestinal tract perforation. AJR Am J Roentgenol. 2006;187:1179-83.
https://doi.org/10.2214/AJR.05.1179
21. Furukawa A, Sakoda M, Yamasaki M, Kono N, Tanaka T, Nitta N, et al. Gastrointestinal tract perforation: CT diagnosis of presence, site, and cause. Abdom Imaging. 2005;30:524-34.
https://doi.org/10.1007/s00261-004-0289-x
22. Imuta M, Awai K, Nakayama Y, Murata Y, Asao C, Matsukawa T, et al. Multidetector CT findings suggesting a perforation site in the gastrointestinal tract: Analysis in surgically confirmed 155 patients. Radiat Med. 2007;25:113-8.
https://doi.org/10.1007/s11604-006-0112-4
23. Maniatis V, Chryssikopoulos H, Roussakis A, Kalamara C, Kavadias S, Papadopoulos A, et al. Perforation of the alimentary tract: Evaluation with computed tomography. Abdom Imaging. 2000;25:373-9.
https://doi.org/10.1007/s002610000022
24. Ongolo-Zogo P, Borson O, García P, Gruner L, Valette PJ. Acute gastroduodenal peptic ulcer perforation: Contrast-enhanced and thin-section spiral CT findings in 10 patients. Abdom Imaging. 1999;24:329-32.
https://doi.org/10.1007/s002619900509
25. Fultz PJ, Skucas J, Weiss SL. CT in upper gastrointestinal tract perforations secondary to peptic ulcer disease. Gastrointest Radiol. 1992;17:5-8.
https://doi.org/10.1007/BF01888496
26. Stapakis JC, Thickman D. Diagnosis of pneumoperitoneum: Abdominal CT Vs. upright chest film. J Comput Assist Tomogr. 1992;16:713-6.
https://doi.org/10.1097/00004728-199209000-00008
27. Kwok KY, Wing TS, Chun NT, Laparoscopic versus open appendectomy for complicated appendicitis. J Am Coll Surg. 2007;205:60-5.
https://doi.org/10.1016/j.jamcollsurg.2007.03.017
28. Ordoñez CA, Puyana JC. Management of peritonitis in the critically ill patient. Surg Clin North Am. 2006;86:1323-49.
https://doi.org/10.1016/j.suc.2006.09.006
29. Mai V, Morris JG. Colonic bacterial flora: Changing understan- dings in the molecular age. J Nutr. 2004;134:459-64.
https://doi.org/10.1093/jn/134.2.459
30. Condon RE. Microbiology of intra-abdominal infection and contamination. Eur J Surg Suppl. 1996;576:9-12.
https://doi.org/10.2165/00128413-199610670-00022
31. Chong AJ, Dellinger EP. Current treatment of intraabdominal infections. Surg Technol Int. 2005;14:29-33.
32. FredericB, Karine P, CarolineM. Emergency laparoscopic management of perforated sigmoid diverticulitis: A promi- sing alternative to more radical procedures. J Am Coll Surg. 2008;206:654-7.
https://doi.org/10.1016/j.jamcollsurg.2007.11.018
33. Shukla PJ, Maharaj R, Fingerhut A. Ergonomics and technical aspects of minimal access surgery in acute surgery. Eur J Trauma Emerg Surg. 2010;36:3-9.
https://doi.org/10.1007/s00068-010-9226-6
34. Myers E, Hurley M, O'Sullivan GC. Laparoscopic peritoneal lavage for generalized peritonitis due to perforated diverticulitis. Br J Surg. 2008;95:97-101.
https://doi.org/10.1002/bjs.6024
35. Martin RF, Rossi RL. The acute abdomen and overview and algorithms. Surg Clin North Am. 1997;77:1227-43.
https://doi.org/10.1016/S0039-6109(05)70615-0
36. de Graff JS, van Goor H, Bleichrodt RP. Primary small bowel anastomosis in generalized peritonitis. Eur J Surg. 1996;162:55-8.
37. Barker DE, Green JM, Maxwell RA, Smith PW, Mejia VA, Dart BW, et al. Experience with vacuum-pack temporary abdominal wound closure in 258 trauma and general and vascular surgical patients. J Am Coll Surg. 2007;204:784-93
https://doi.org/10.1016/j.jamcollsurg.2006.12.039
38. Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving sepsis and septic shock. Intensive Care Med. 2004;30:536-55.
https://doi.org/10.1007/s00134-004-2210-z
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Publicado
2012-01-01
Cómo citar
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Barragán, C.; Rueda, J. D.; Espitia, E.; Uriza, L. F.; Rosselli, D. Perforación Intestinal Por Espina De Pescado, revisión De La Literatura científica Y presentación De Dos Casos. Rev Colomb Cir 2012, 27, 79-84.
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Todos los textos incluidos en la Revista Colombiana de Cirugía están protegidos por derechos de autor. Las opiniones expresadas en los artículos firmados son las de los autores y no coinciden necesariamente con las de los directores o los editores de la Revista Colombiana de Cirugía. Las sugerencias diagnósticas o terapéuticas como elección de productos, dosificación y métodos de empleo corresponden a la experiencia y al criterio de los autores.
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