Progutani magneti kao redak uzrok ileusa kod odraslih

  • Krstina Doklestić Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Zlatibor Lončar Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Bojan Jovanović Clinical Center of Serbia, Department for Anaesthesiology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Jelena Veličković Clinical Center of Serbia, Department for Anaesthesiology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP160214299D
Ključne reči: foreign bodies||, ||strana tela, magnetics||, ||magnetika, intestinal obstruction||, ||creva, opstrukcija, digestive system surgical procedures||, ||hirurgija digestivnog sistema, procedure,

Sažetak


Uvod. Progutano magnetno strano telo je bezazleno ukoliko je pojedinačno. Kod gutanja većeg broja pojedinačnih magneta u vremenskim razmacima oni se mogu međusobno snažno privući kroz zid creva i izazvati ozbiljna oštećenja. Prikaz bolesnika. Prikazali smo slučaj 21-godišnjeg muškarca koji je, nakon što je progutao dva mala magneta, razvio kliničke i radiografske znake akutne crevne okluzije i intestinalne fistule. Uzrok ileusa detektovan je tek tokom laparotomije. Pri laparotomiji jedan magnet pronađen je u vijuzi proksimalnog jejunuma, a drugi u distalnom ileumu. Bili su snažno međusobno privučeni, sa uvrtanjem preostalih vijuga tankog creva oko formirane tačke rotacije, uzrokujući kompletnu crevnu opstrukciju sa strangulacijom tankog creva i jejuno-ilealnom fistulom. Crevne vijuge su oslobođene i mesta perforacije su zbrinuta primarnom suturom creva. Oporavak je protekao bez komplikacija. Bolesnik je otpušten iz bolnice petog postoperativnog dana. Zaključak.  Ukoliko je pacijent progutao više pojedinačnih magneta i razviju se znaci akutne intestinalne okluzije, potrebna je brza hirurška intervencija da bi se sprečile ozbiljne komplikacije.

Biografije autora

Krstina Doklestić, Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia

Specijalista opšte hirurgije, Klinički  Asistent na Katedri za hirurgiju sa anesteziologijom, Medicinskog fakulteta Univerziteta u Beogradu

Zlatibor Lončar, Clinical Center of Serbia, Clinic for Emergency Surgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia

specijalista opšte hirurgije

dr sci. med.

Bojan Jovanović, Clinical Center of Serbia, Department for Anaesthesiology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
specijalista anestezije
Jelena Veličković, Clinical Center of Serbia, Department for Anaesthesiology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
specijalista anestezije

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Objavljeno
2017/11/28
Broj časopisa
Vol. 74 Br. 11 (2017)
Rubrika
Prikaz bolesnika