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( Omer Tekin ),( Veysel Ozalper ),( Mesut Tiglioglu ),( Yalcin Onem ),( Fehim Diker ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Objective: Gastrointestinal foreign bodies(GFB) may cause problems in all age groups. After gastrointestinal bleeding, they are second common indication for urgent gastrointestinal endoscopy. Case Report: A 20-year-old male was admitted to our Emergency Service complaining of vomiting and severe abdominal pain. The patient reported postprandial nausea and vomiting for last 2 days and a repair operation for perforated duodenal ulcer a year ago. Physical examination revealed an abdominal distension with the lack of peritoneal irritation signs (e. g. rebound, rigitidy). Laboratory tests including complete blood count, acute phase reactants, serum electrolytes, liver function tests, amylase and lipase levels were normal. Plain abdominal X-ray showed that the stomach was distented with intestinal gas and 3 signifi cant air-fi uid levels were seen in bowels at different heights(fi gure-1). Upper gastrointestinal endoscopy was performed for ruling out the mechanical obstruction. Endoscopy revealed that infi ammation and edema caused by three silky stitchs remained ex-surgery. Infi ammation and edema caused to subileus were seen on the duodenal mucosal wall affected by silky suture materials( fi gure-2). Patient required a therapeutic intervention with proper methods of extraction to alleviate the symptoms. Non absorbable surgical suture material was taken out by endoscopic procedure. After the endoscopic intervention patient`s complaints decreased signifi cantly. He was treated with a proton pump inhibitor and a prokinetic agent. The symptoms improved by treatment. Conclusion: Long standing GFB may conclude infiammation, edema, ulceration or perforation in the gastric and duodenal wall. Many foreign bodies pass the gastrointestinal tract, spontaneusly. But iatrogenic foreign body (silky suture-mediated) need urgent intervention.