Intestinal foreign bodies: symptoms

In most cases, patients themselves consult a doctor about a swallowed foreign body, but they do not make any complaints, sometimes they indicate a feeling of "sadness" in the throat behind the sternum (in the esophagus) that arises or worsens upon swallowing; in some cases, there is a spastic pain in the abdomen. Often, these unpleasant sensations are caused by mild traumatization of the mucous membrane of the pharynx or esophagus by a badly chewed piece of tight, stiff food. The patient is afraid and thinks that during the meal he swallowed pieces of beef, chicken or fish bone. However, the conducted foreign body investigations in the digestive tract do not reveal.

It should be borne in mind that if a swallowed foreign body has not been delayed in the esophagus and stomach, then most often by the time the patient gets to the doctor and is examined by x-ray (usually 3-4 hours or more after ingestion), the foreign body is already in thin or the caecum.

In other cases, severe abdominal pain is noted, and body temperature rises. The physician should carefully question the patient about the nature of the alleged foreign body, the circumstances under which it was ingested, examine the pharynx, palpate the neck, stomach, trying to detect areas of soreness, muscle tension in the anterior abdominal wall and even in some cases to palpate the foreign body if it is large enough , and the abdominal wall of the patient is not stressed and there is no large subcutaneous fat layer. Then methodically conduct an X-ray: first examine the pharynx and esophagus, then - the stomach, duodenum and other departments.

With a favorable course, which is observed in most cases, the foreign body of the intestine leaves during defecation, and it can often be found in stool. In cases where the foreign body was delayed in the intestine, especially if it has sharp edges or a sharpening at the end, various complications are possible. They can be divided into the early, emerging within the next hours or several days after ingestion of the foreign body, and later, appearing after many days, weeks, months, and in some cases even years.

One of the relatively rare closest serious complications is the perforation of the intestinal wall of the intestine with the development of peritonitis or more often isolated by abscess adhesions. In a number of cases, the foreign body embedded in the intestinal wall is encapsulated without the development of an abscess. Its further fate may be different: either the foreign body remains encapsulated for a long time without causing significant disturbances in the patient's condition, or pain develops in the abdomen more often, the general condition is broken, the temperature periodically rises. In the future, the abscess can be opened into the gut or outward through the abdominal wall. With foreign bodies that caused perforation of the walls of the blind or rectum with the development of a limited abscess, penetration into the bladder and vagina, as well as the formation of fistulas of the anus can occur.

Among other complications when foreign bodies enter the intestine, one should keep in mind the possibility of intestinal bleeding, which, however, is very rarely profuse. Foreign bodies of large size can cause obturation intestinal obstruction (large fruit bones, large conglomerates of ascarids, large gallstones that enter the intestine when forming a fistula between the gall bladder and bowel, which is observed with purulent calculous cholecystitis rarely).

[1], [2], [3], [4], [5], [6], [7], [8], [9]