对 COVID 阳性患者吞入异物的处理。

Tiffany Smith, Rachel Blum, Raquel Rozdolski
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引用次数: 0

摘要

本病例报告描述了一名 51 岁的男子在牙科治疗过程中吞下了一块脱落的汞合金碎片,而当时并没有进行咽喉筛查。患者被转到急诊科,经放射成像检查证实异物位于食道。食管异物通常通过食管胃十二指肠镜检查(EGD)取出。然而,这起事件发生在 2020 年 9 月,正值 COVID-19 大流行的高峰期。由于患者术前 COVID-19 检测呈阳性,因此按照医院的规定,无法进行胃肠镜检查。相反,由于异物体积小且患者没有呼吸困难的体征和症状,因此必须采用无创方法并进行连续的射线监测,以观察碎片通过胃肠道时的情况。本病例报告强调了在每次牙科手术中使用气道保护措施的重要性。此外,可能有必要重新评估将胃肠道造影术作为治疗误食小异物的黄金标准。
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Management of an Ingested Foreign Body in a COVID-Positive Patient.

This case report describes a 51-year-old man who swallowed an amalgam fragment dislodged during dental treatment performed without a throat screen. The patient was transferred to the emergency department, where the foreign body was confirmed to be in the esophagus following radiographic imaging. Foreign body removal from the esophagus is routinely achieved via esophagogastroduodenoscopy (EGD). However, this incident occurred in September 2020, at the height of the COVID-19 pandemic. Because of the patient's preoperative positive COVID-19 test, the option for EGD retrieval was eliminated per hospital protocol. Instead, a noninvasive approach with serial radiographic monitoring was deemed mandatory to observe the fragment as it passed through the gastrointestinal tract, warranted by the small size of the foreign body and the patient's lack of signs and symptoms of respiratory distress. This case report reinforces the importance of using airway protection during every dental procedure. Furthermore, reevaluation of EGD as the gold standard for treatment of ingested small materials may be warranted.

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