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NEJM：吃鸡导致的意外-病例报道

2018-05-03 xing.T MedSci原创

鸡骨气短发热气管
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由于右侧支气管走形更加垂直和管腔更加宽大，异物通常会滞留在支气管树的右侧，而不是左侧。由于轻微症状而延迟诊治可能会导致炎症和感染。

患者为一名78岁的男性，因惊恐、气短和发热（38.1°C）到急诊就诊。五天前，他在吃鸡时发生呛人事件，感到喉咙里有异物，后约一个小时到急诊就诊。在当时，接受颈部和胸部的体格检查和平面X光照片并无异常。据推测异物已经移位，患者出院回家。

在本次就诊中，计算机断层扫描显示右主干支气管中存在鸡脊椎形状的高衰减结构（如箭头所示）。右下肺叶有轻微肺不张，没有肺叶塌陷的证据。



由于右侧支气管走形更加垂直和管腔更加宽大，异物通常会滞留在支气管树的右侧，而不是左侧。由于轻微症状而延迟诊治可能会导致炎症和感染。

该患者接受了支气管镜检查，成功取出鸡骨。手术后患者恢复良好，并在第3天出院。

原始出处：

Huey Ming Seah,et al.Aspiration of a Chicken Bone. N Engl J Med 2018;https://www.nejm.org/doi/full/10.1056/NEJMicm1713423

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    2018-05-09 执迷不悔

    学习了

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    2018-05-09 执迷不悔

    很好的文章

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    2018-05-05 15938038573红旗飘飘

    已学习

    0

  4. 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channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Thu May 03 08:23:18 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-05-05 秀红

    学习了

    0

  5. 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channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Thu May 03 08:23:18 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-05-05 曾超军

    厉害

    0

  6. 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channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Thu May 03 08:23:18 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-05-04 技能冷却中

    我以为是大吉大利的吃鸡

    0

  7. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Thu May 03 09:36:08 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311579, encodeId=702d3115e995, content=谢谢学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu May 03 08:32:58 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311573, encodeId=1aa23115e39a, content=学习了.谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Thu May 03 08:23:18 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-05-04 flysky120

    具体病情还需要具体检查一下

    0

  8. 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channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Thu May 03 08:23:18 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-05-03 王秀

    学习了.涨知识了!

    0

  9. 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channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Thu May 03 08:23:18 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-05-03 龙胆草

    谢谢学习谢谢分享

    0

  10. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDM9swhbgTo7nzqRKzMmzckmEoeTyLQVDCgjqsicjyhxPs0vPoYU6GsSYbCjSkNHicJkz3NL0a0EbUMVdNjkctXI6FocpGKaVr9E/0, createdBy=29392048316, createdName=王秀, createdTime=Thu May 03 09:36:08 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311579, encodeId=702d3115e995, content=谢谢学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Thu May 03 08:32:58 CST 2018, time=2018-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=311573, encodeId=1aa23115e39a, content=学习了.谢谢作者分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3xJXLtMtt5B40XXuPjn9xn1rBhrM6fHLkX1hI86ZoWoPJkgDkZuJNKkBfBHOcRd1fAdezg7JlHNOokohdAp3WkI/0, createdBy=32c81964262, createdName=1e145228m78(暂无匿称), createdTime=Thu May 03 08:23:18 CST 2018, time=2018-05-03, status=1, ipAttribution=)]
    2018-05-03 1e145228m78(暂无匿称)

    学习了.谢谢作者分享!

    0

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