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題名 | An Ingested Fish Bone Migrating to the Thyroid Gland--A Case Report=上消化道異物魚刺遊走至甲狀腺--病例報告 |
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作者 | 林育興; 何旭爵; 蕭士軒; | 書刊名 | 慈濟醫學 |
卷期 | 18:6 民95.12 |
頁次 | 頁438-441+468 |
分類號 | 416.898 |
關鍵詞 | 食道異物; 魚刺; 遊走; 甲狀腺; 頸部超音波; Migration; Fish bone; Thyroid gland; Neck ultrasonography; Neck exploration; |
語文 | 英文(English) |
中文摘要 | 雖然食道異物在耳鼻喉科急診經常被遇到,但異物穿破出食道及遊走至甲狀腺的情況則是非常少見,過去只有幾例曾被記載於文獻報告。本院耳鼻喉科經歷一位70歲女性主訴在誤食魚刺後出現喉嚨異物感及吞嚥疼痛的情形,雖然食道鏡手術並無發現異物,然而過數天後左側頸部突然腫大及劇烈疼痛,頸部超音波顯示左側甲狀腺出現異物陰影,故病人接受頸部探查手術。於左側甲狀腺的內側靠氣管處發現一個大小約3公分的線狀魚刺併周圍甲狀腺組織膿瘍。經異物取出及清瘡手術後,病人病況迅速好轉。突發性甲狀腺腫大併誤食異物病史,應使我們警覺到遊走性異物至甲狀腺及次發性急性發炎的可能性。頸部超音波在偵查甲狀腺異物的靈每性優於電腦斷層掃描,手術移除異物應儘早實施。 |
英文摘要 | Although hypopharyngeal fish bones are common otolaryngological emergencies, it is extremely rare for fish bones to migrate into the thyroid gland, with few cases reported in the literature. We report the case of a 70-year-old woman who complained of dysphagia, odynophagia, and pain on the left side of the neck after ingestng a fish bone, Cervical ultrasonography revealed a foreign body shadow in the thyroid gland, and the patient underwent neck exploration. A pointed fish bone was located in the medial part of the left thyroid gland near the tracheal wall, with surrounding abscess formation in the thyroid. A case involving an enlarging thyroid mass with a history of foreign body ingestion should alert the physician to the possibility of a penetrating foreign body migrafting into the thyroid gland with subsequent infection and inflammation. Cervical ultrasonography is more use3ful in detecting a foreign body in the thyroid gland than computed topography. The foreign body should be surgically removed as soon as possible. |
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