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Small intestinal foreign bodies

  Small intestinal foreign bodies are mostly various items accidentally or intentionally swallowed, the former being more common in children, individuals with mental abnormalities, or denture wearers, and the latter more common in those attempting suicide. The clinical symptoms are closely related to the length, size, shape, texture, and weight of the foreign bodies. Abdominal distension, constipation, and even vomiting may occur; if the foreign body penetrates or embeds in the intestinal wall, it can cause abdominal pain, infection, and fever; if the foreign body injures the intestinal mucosa, it can cause ulcers and bleeding.

Table of Contents

1. What are the causes of small intestinal foreign bodies?
2. What complications can small intestinal foreign bodies easily lead to?
3. What are the typical symptoms of small intestinal foreign bodies?
4. How to prevent small intestinal foreign bodies?
5. What kind of laboratory tests need to be done for small intestinal foreign bodies?
6. Dietary taboos for patients with small intestinal foreign bodies
7. Conventional methods of Western medicine for treating small intestinal foreign bodies

1. What are the causes of small intestinal foreign bodies?

  1. Causes of Disease

  1. Exogenous foreign bodies in the intestines are mostly various items accidentally swallowed, such as fish bones, fruit pits, buttons, coins, teeth, dentures, toothpicks, hairpins, keys, needles, and nails, etc.; those who intentionally swallow them are usually attempting suicide or patients with mental illness, intentionally swallowing items such as rings, chopsticks, toothbrush handles, toothpaste tubes, keys, blades, small knives, glass pieces, needles, and nails, etc. In addition, drug traffickers also intentionally swallow bags of drugs to avoid customs inspections.

  2, Endogenous foreign bodies include ascaris balls, enteric stones entering the small intestine, gallstones entering the duodenum, and primary small intestinal calculi.

  Second, Pathogenesis

  Generally speaking, most ingested foreign bodies that can pass through the esophagus will also be able to pass through other parts of the digestive tract without obstruction and be excreted from the body through feces. A few may remain embedded in the pylorus, duodenojejunal flexure, or ileocecal valve. Blunt foreign bodies can be excreted more quickly, while sharp foreign bodies can pierce the intestinal wall to form localized abscesses or granulomas. There are also reports that after years of swallowing foreign bodies, abscesses or granulomas occurred in the ileocecal region. Sharp foreign bodies can also cause intestinal perforation, which often occurs at the appendix or Meckel diverticulum.

2. What complications can small intestinal foreign bodies easily lead to

  Most small intestinal foreign bodies in patients have no自觉 symptoms, and sometimes they can cause intestinal obstruction. Small intestinal foreign bodies can bring inconvenience to the patient's life, and in severe cases, they can cause intestinal perforation and gastrointestinal bleeding. It is necessary to receive timely treatment.

3. What are the typical symptoms of small intestinal foreign bodies

  The clinical symptoms caused by small intestinal foreign bodies are closely related to the length, size, shape, texture, and weight of the foreign body. Most small intestinal foreign bodies have no自觉 symptoms, and sometimes they can cause intestinal obstruction. Foreign body obstruction can cause abdominal distension, constipation, and even vomiting; foreign body penetration or embedding in the intestinal wall can cause abdominal pain, infection, and fever; foreign body injury to the intestinal mucosa can cause ulcers and bleeding; foreign body tearing of the intestinal wall can cause perforation and acute peritonitis; the packaging bags of packaged drugs can cause poisoning symptoms if they are broken and the drugs leak.

4. How to prevent small intestinal foreign bodies

  Foreign bodies in the intestines can be prevented. For infants and young children, attention should be paid not to place items that may be swallowed beside them. Children should be educated to develop good hygiene habits, not to put items other than food in their mouths to play with. Adults should not put nails, needles, and other items in their mouths while working.

5. What kind of laboratory tests are needed for small intestinal foreign bodies?

  X-ray (transparency and photography) has diagnostic and locational value for opaque foreign bodies. If the foreign body contains metal, it can be traced and observed under X-ray. Fine metal foreign bodies may sometimes need to be photographed to be seen clearly. Non-metallic foreign bodies require barium enema examination or small intestinal fiberoptic endoscopy to make a diagnosis. As for X-ray-permeable foreign bodies, some can also obtain diagnostic intention, such as the 'coarse felted ball' shape shadow around the umbilicus visible in the X-ray flat film of ascaris balls, the smooth bag-shaped shadow with increased density visible in the swallowed packaged drugs, and endoscopic examination can obtain a diagnosis. If there is no symptom but a history of accidental swallowing of foreign bodies, the feces should be carefully examined first, which can be excreted spontaneously in 3 to 5 days. Do not use laxatives. If there is still no excretion after 1 week, perform barium enema or small intestinal endoscopy.

6. Dietary Recommendations and Contraindications for Small Intestine Foreign Body Patients

  Diet should include foods rich in protein and other nutrients, such as lean meat, beef, mushrooms, jujube, sesame, etc. In addition, food for preventing and treating deficiency syndrome includes black fungus, yam, coriander, chive, eggplant, euryale, lotus root, fennel, lychee, chicken, mutton, fig, etc.

7. The conventional method of Western medicine for treating small intestine foreign bodies

  1. Drug Treatment

  For patients with small intestine foreign bodies without symptoms and signs, liquid diet and laxatives such as liquid paraffin and magnesium sulfate can be taken to promote the excretion of the foreign body, while daily X-ray examination is monitored and observed for its movement until the foreign body is excreted.

  2. Endoscopic Removal

  For foreign bodies that are sharp and pointed, with a length of 6-10 cm or a diameter less than 2 cm, and confirmed by X-ray examination to be in the duodenum, the foreign body can be removed using an endoscope and appropriate foreign body forceps.

  3. Surgical Operation

  Small Intestine Foreign Bodies such as Intestinal Obstruction and Other Complications should not be operated on lightly. They can be observed closely and the stool examined carefully. If the foreign body remains in a certain position for several days without change, it indicates the possibility of impaction, or if the foreign body is thin and pointed, there is a risk of piercing the intestinal wall, then emergency surgery should be performed to perform enterotomy and remove the foreign body. If there is fever, abdominal pain, tenderness, and an elevated white blood cell count, surgery should be performed early. However, X-ray examination should be performed again before surgery to determine the position of the foreign body and prevent its displacement or expulsion. During the operation, the entire small intestine should be checked to avoid missing the foreign body, and it is generally not necessary to perform enterectomy. If there is no concurrent diverticula or changes in intestinal wall ischemia, or if the foreign body mass is not too large and not hard, it can also be pushed into the cecum with the stool, but the technique should be gentle.

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