ĐẶC ĐIỂM HÌNH ẢNH VÀ ĐIỀU TRỊ DỊ VẬT XÂM NHẬP QUA ĐƯỜNG TIÊU HÓA, DƯỚI CƠ HOÀNH TẠI BỆNH VIỆN ĐẠI HỌC Y HÀ NỘI

Abstract

Gastrointestinal foreign bodies are very common condition in clinical practice. Gastrointestinal foreign bodies below the diaphragm are less common but are also very dangerous and can lead to serious complications and even death if not detected and treated timely. Foreign bodies typically enter through the mouth. Diagnosis is mainly based on computed tomography, which helps provide an accurate view of the characteristics of shape, size, location as well as complications of foreign bodies. Currently, the commonly used foreign body removal methods are endoscopy, surgery and percutaneous intervention. Each method has different indications as well as advantages and disadvantages, and the choice of secondary treatment methods. Depends a lot on the visual characteristics of the foreign body as well as accompanying complications. This study aims to describe the imaging characteristics of foreign bodies in the gastrointestinal tract below the diaphragm, and foreign body characteristics related to treatment choice. Objectives: Describe the imaging characteristics of foreign bodies in the gastrointestinal tract below the diaphragm and the imaging characteristics of foreign bodies related to the selection of treatment methods. Subjects and methods: A cross-sectional descriptive study on 49 patients (17 women/32 men) with There is a foreign body entering the digestive tract below the diaphragm at Hanoi Medical University Hospital from January 2021 to May 2024. Result: In our study, the majority of foreign bodies under the diaphragm that require treatment intervention are long, pointed foreign bodies (93.9%), of which the majority are fish bones and toothpicks (accounting for 78.5% of foreign bodies identified). determined). 45/49 patients (91.8%) had 1 foreign body, 4 patients had > 1 foreign body. The most common complication of foreign bodies under the diaphragm requiring intervention is perforation, 73.5%. The most common location of foreign bodies under the diaphragm requiring treatment intervention is in the small intestine (34.7%). The majority of foreign bodies removed by endoscopy are located in the stomach and colorectum. Laparoscopic surgery accounts for the highest rate in foreign body removal treatment at 32.7%, Percutaneous foreign body removal intervention accounts for 14/49 cases (28,6%), mainly chosen in cases where foreign bodies are located outside the digestive tract. chemotherapy in 8/12 patients. The overall success rate of foreign body removal reached 77.6%. Conclusion: Diagnosis of foreign bodies in the gastrointestinal tract below the diaphragm is mainly based on computed tomography, which helps provide an accurate view of the characteristics of shape, size, location as well as complications of foreign bodies, thereby helping to diagnose foreign bodies. Endoscopy is the first treatment option if the location is convenient to reach the foreign body, surgery is recommended when endoscopy fails or is not indicated. Percutaneous intervention to remove foreign bodies from the digestive tract is a new technique but has initially shown very positive results