Opstrukcija tankog crijeva stranim tijelom u bolesnika s Crohnovom bolesti [Foreign body as a cause of small bowel obstruction in patient with Crohn's disease]

Domislović, Viktor and Brinar, Marko and Turk, Nikša and Čuković-Čavka, Silvija and Barišić, Ana and Kekez, Tihomir and Krznarić, Željko (2018) Opstrukcija tankog crijeva stranim tijelom u bolesnika s Crohnovom bolesti [Foreign body as a cause of small bowel obstruction in patient with Crohn's disease]. Liječnički vjesnik, 140 (9-10). pp. 254-257. ISSN 0024-3477

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Abstract

Foreign body in digestive tract is a rare cause of intestinal obstruction. Most foreign bodies pass digestive tract spontaneously. Endoscopic intervention will be needed in approximately 10-20%, and surgical intervention in less than 1% of cases. People with increased risk of foreign body obstruction are those with previous abdominal operation, hernia, tumor, Crohn’s disease or congenital intestinal malformations. In this paper we have presented a patient with Crohn’s disease and stenosis of terminal ileum with prestenotic dilatation hospitalized due to bowel obstruction caused by foreign body in terminal ileum. Surgicaly removed foreign body was peach pit stuck in the ileocaecal valve. Except of the most common causes of small bowel obstruction, it is necessary to bear in mind the rare causes of obstruction and consider them in differential diagnosis, especially in patients with Crohn’s disease, due to timely intervention and lowering the possibility of developing complications such as perforation, bleeding or fi stula formation.

Abstract in Croatian

Strano tijelo u probavnom sustavu pripada rjeđim uzrocima crijevne opstrukcije. Većina stranih tijela spontano će proći cijelim probavnim traktom. Endoskopska intervencija bit će potrebna u 10 – 20% bolesnika, a kirurški zahvat u manje od 1% njih. Osobe povišenog rizika od zastoja stranog tijela jesu one s prethodnim kirurškim zahvatom u abdomenu, hernijom, tumorom, Crohnovom bolesti ili prirođenim malformacijama crijeva. U radu smo prikazali bolesnicu s Crohnovom bolesti i stenozama terminalnog ileuma s prestenotičkom dilatacijom, koja je hospitalizirana zbog opstruktivnih smetnja uzrokovanih stranim tijelom u području terminalnog ileuma. Strano tijelo uklonjeno operativnim putem bila je koštica breskve zaglavljena u ileocekalnoj valvuli. Postoperativni tijek protekao je bez komplikacija. Osim najčešćih uzroka opstrukcije tankog crijeva, potrebno je imati na umu i rijetke uzroke opstrukcije i uzeti ih u obzir pri diferencijalnodijagnostičkom razmišljanju, osobito u bolesnika s Crohnovom bolesti, kako

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