직장 천공을 일으킨 연한 직장 이물질 1예
A Case of a Colon Perforation Due to a Soft Rectal Foreign Body
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초록
지금까지 국내에 보고된 직장 이물에 대한 대부분의 증례는 경구 섭취로 발생한 사례이고, 항문을 통한 직접 삽입에 의한 직장 이물 보고는 2예가 있었다. 그러나 2예 모두 경성 직장 이물로, 켈리 클램프를 이용한 직접 제거나 수술적 제거로 치료한 보고들이었으며, 연성 직장 이물이나, 천공의 합병증이 동반된 직장 이물을 치료한 예는 없었다. 본 증례는 내원 전일 소시지를 항문으로 삽입 한 환자가 내시경 제거의 실패와 결장 천공의 합병증까지 발생한 직장 이물 증례 보고로, 향후 직장 내 연성 이물의 내시경 제거에 관한 여러 연구들이 더 필요할 것으로 판단되어 문헌 고찰과 함께 보고한다.
Abstract
Numerous foreign bodies in the rectum have been reported in the literature. Their removal can be challenging depending on the size and shape of the objects and their anatomical location in the rectum. A 64-year-old man presented to the emergency department after inserting a sausage into his rectum. He had some rectal discomfort and lower abdominal pain. There were no signs of bowel perforation. We attempted to extract the sausage impacted in the recto-sigmoid junction by colonoscopy using a snare and grasping forceps but failed to extract the foreign body. Unfortunately, a colon perforation had occurred, and the sausage was eventually extracted by performing a colostomy at the recto-sigmoid junction with primary repair. We report this case of a soft rectal foreign body impacted in the recto-sigmoid colon complicated by a colon perforation with a literature review.
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