CLINICAL AND X-RAY JUSTIFICATION OF EXNER’S REFLEX SIGNIFICANCE IN CASE OF SHARP INGESTED FOREIGN BODIES IN THE GASTROINTESTINAL TRACT: CLINICAL CASE REPORT
https://doi.org/10.17238/issn2072-3180.2020.3.103-107
Abstract
Sharp ingested foreign bodies in the digestive tract are quite a rare find in the clinical practice of urgent abdominal surgery. Such cases are more likely to be found among mental, observed in mentally ill patients, prisoners, elderly and drug addicts. Accidental cases are actually quite seldom. Sharp foreign bodies are mainly ingested on purpose due to the changed mental state. However, this does not make them any less dangerous. The way the objects pass through the digestive tract strongly depends on their size and characteristics. The passage becomes slightly easier when a foreign body goes through the stomach. Most cases with a basic (uncomplicated) passage are insympathetic, which makes them very difficult to diagnose. According to Exner's reflex, sharp foreign bodies within the gut can travel freely, without any damage to the gastrointestinal tract by inhibiting the contractions of the overlaying muscle so that perforation will be avoided. The sharp edges of the foreign body irritate the mucous membrane causing the tightening of the mucous. That makes the object turn gradually to present its blunt edges, provided that the length of the object does not exceed the lumen of the intestine. The clinical observation shows the manifestation of the ‘needle’ reflex described by Exner in 1902, which allowed us to dispense with surgery and avoid complications, which in many cases are fatal.
About the Authors
I. V. Yarema
Evdokimov Moscow state medical University
Russian Federation
Russian Federation
Yarema Ivan Vasilyevich — head of the Department, corresponding member of the Russian Academy of Sciences, MD, Professor. Evdokimov Moscow state medical University, Department of Hospital surgery
20/1 Delegatskaya str., Moscow, 127473
D. V. Nikolaev
Evdokimov Moscow state medical University;
Bakhrushin brothers state hospital of the Moscow city health Department
Russian Federation
Russian Federation
Dmitry Vladimirovich Nikolaev — doctor-surgeon. Moscow state medical University named after A. I. Evdokimov, assistant of Department of Hospital surgery
20/1 Delegatskaya str., Moscow, 127473;
Doctor-surgeon of the surgical Department of the Bakhrushin brothers state hospital of the
Moscow city health Department
7 Stromynka street, Moscow, 107014
N. V. Luninа
Evdokimov Moscow state medical University
Russian Federation
Russian Federation
Luninа Natalia V. — resident doctor of the Department of Hospital surgery doctor of MSMSU them. A. I. Evdokimov
127473, Moscow, Delegatskaya str. 20/1
V. S. Fomin
Evdokimov Moscow state medical University;
Veresaev state hospital of the Moscow city health Department, surgical Department
Russian Federation
Russian Federation
Fomin Vladimir Sergeevich — associate Professor, surgeon Department of surgical diseases and clinical angiology of the faculty of dentistry doctor of MSMSU them. A. I. Evdokimov
127473, Moscow, Delegatskaya str., 20/1, Russia, GSC.
them. V.V. Veresaeva health Department of the city of Moscow, 127411, lobnenskaya str., 10, Moscow
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Review
For citations:
Yarema I.V., Nikolaev D.V., Luninа N.V., Fomin V.S. CLINICAL AND X-RAY JUSTIFICATION OF EXNER’S REFLEX SIGNIFICANCE IN CASE OF SHARP INGESTED FOREIGN BODIES IN THE GASTROINTESTINAL TRACT: CLINICAL CASE REPORT. Moscow Surgical Journal. 2020;(3):103-107. (In Russ.) https://doi.org/10.17238/issn2072-3180.2020.3.103-107
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