ﺷﺪه ﮔﺰارش ﯾﮏ ﻣﻮرد ﺟﺴﻢ ﺧﺎرﺟﯽ ﻓﺮاﻣﻮش ﻣﺘﺮي در ﮔﻮﻧﻪ ﺑﯿﻤﺎر

(1)

شﻮﻣاﺮﻓ ﯽﺟرﺎﺧ ﻢﺴﺟ درﻮﻣ ﮏﯾ شراﺰﮔ هﺪﺷ

6 ﯽﺘﻧﺎﺳ رﺎﻤﯿﺑ ﻪﻧﻮﮔ رد يﺮﺘﻣ

ﺢﺘﻔﻣ ﺎﺿرﺪﻤﺤﻣ

،1

ﯽﯾﻮﮕﻧز ﻪﺤﯿﻠﻣ ،2

ﺖﯿﻟﻮﺗ ﻢﯾﺮﻣ 3

هﺪﯿﮑﭼ

لﺎﺣ حﺮﺷ ﻪﺑ ﻪﺟﻮﺗ مﺪﻋ ﻖﯿﻗد ﻪﻨﯾﺎﻌﻣ مﺪﻋ و

،رﺎﻤﯿﺑ ﯽﻣ ﻪﺑ ﺪﻧاﻮﺗ ﯽﻧﺎﻣرد و ﯽﺼﯿﺨﺸﺗ تﻼﮑﺸﻣ ﺮﺠﻨﻣ

ددﺮﮔ . رد ﻦﯾا

،ﻪﻟﺎﻘﻣ ﻢﺴﺟ ﮏﯾ دﻮﺟو

شﻮﻣاﺮﻓ ﯽﺟرﺎﺧ ﺪﺷ

ﻪﻧﻮﮔ رد ه ﯽﻣ شراﺰﮔ رﺎﻤﯿﺑ ددﺮﮔ

.

رﺎﻤﯿﺑ

، ﺮﺘﺧد 9 ﻪﻟﺎﺳ يا ﮏﯾ عﺎﻔﺗرا زا طﻮﻘﺳ ﻪﻘﺑﺎﺳ ﻪﮐ ﺖﺳا يﺮﺘﻣ

ار ﯽﻟﺎﺣ رد طﻮﻘﺳ ﻦﯿﺣ و هدﻮﺑ ﺶﺘﺳد رد داﺪﻣ ﮏﯾ ﻪﮐ

، ﻪﻧﻮﮔ رد داﺪﻣ

يو و ﻪﺘﻓر وﺮﻓ ﻪﺘﺴﮑﺷ ﺖﺳا ﯽﻣ ﺮﮐذ ، ﺪﻨﮐ . ﻪﻌﺟاﺮﻣ زا ﺲﭘ رﺎﻤﯿﺑ

ﺲﻧاژروا ﻪﺑ و

ﯽﻓاﺮﮔﻮﯾدار ﻦﺘﻓﺮﮔ

، ﯽﻣ ﻪﯿﺨﺑ ،ﯽﮔرﺎﭘ ﻞﺤﻣ ﺮﮔ

دد رﺎﻤﯿﺑ و ﺎﺑ

ﯽﺘﻧآ ﯽﯾوراد رﻮﺘﺳد ﯽﻣ ﺺﺧﺮﻣ ﮏﯿﺗﻮﯿﺑ

ددﺮﮔ . ﺺﯿﺧﺮﺗ زا ﺪﻌﺑ ﻪﺑ ،رﺎﻤﯿﺑ ،

رّﺮﮑﻣ رﻮﻃ ﻢﺧز ﻞﺤﻣ ﺢﺷﺮﺗ و درد زا و هدﻮﻤﻧ ﻪﻌﺟاﺮﻣ ﮏﺷﺰﭘ ﻪﺑ

ﯽﻣ ﺖﯾﺎﮑﺷ ﺪﻨﮐ

؛ ﺖﯾﺎﻬﻧ رد زا سﻮﻨﯿﺳ و ترﻮﺻ لازﺎﻧارﺎﭘ يﺎﻫ

،رﺎﻤﯿﺑ

CT SCAN

ترﻮﺻ لاﺮﭙﺳا ﻣ

ﯽ ﮔﯿ دﺮ . رد

CT SCAN

، ﮏﯾ ﺮﯾﻮﺼﺗ

ﺎﺧ ﻢﺴﺟ ﻪﺘﯿﺴﻧاد ﻪﺑ رﻻﻮﺑﻮﺗ ﯽﺟر

لﻮﻃ 60 ﯽﻠﯿﻣ ﺮﺘﻣ ﻪﻧﻮﮔ ﻞﺤﻣ رد هﺪﻫﺎﺸﻣ

ﯽﻣ ﺷ ﻮ د رﺎﻤﯿﺑ ،ﻪﺠﯿﺘﻧ رد و ﺺﯿﺨﺸﺗ زا ﺪﻌﺑ

، ﻞﻤﻋ ﺖﺤﺗ

ﯽﺣاﺮﺟ ﯽﻣ راﺮﻗ دﺮﯿﮔ .

ﻪﯿﻟوا ﯽﮑﯾﺰﯿﻓ تﺎﻨﯾﺎﻌﻣ و رﺎﻤﯿﺑ لﺎﺣ حﺮﺷ ،نارﺎﻤﯿﺑ ﺎﺑ درﻮﺧﺮﺑ رد

، ﯽﻣ ﺢﯿﺤﺻ ﺺﯿﺨﺸﺗ ﻪﺑ ار ﮏﺷﺰﭘ ﻪﮐ ﺪﻨﺘﺴﻫ ﯽﻠﻣاﻮﻋ ﻦﯾﺮﺘﻤﻬﻣ ﺎﺳر

ﻧ و ﺪﻨ

موﺰﻟ ترﻮﺻ رد

، مﺎﺠﻧا ﯽﺳ ﯽﺗ ﻦﮑﺳا

، ﻪﺑ يدﺎﯾز ﮏﻤﮐ ﺨﺸﺗ

ﯿ ﺺ اﯾ ﻦ دراﻮﻣ ﺪﻫاﻮﺧ دﻮﻤﻧ .

هژاو يﺪﯿﻠﮐ يﺎﻫ ﯽﺟرﺎﺧ ﻢﺴﺟ:

؛ مﺮﻧ ﺞﺴﻧ

؛ ﯽﻓاﺮﮔﻮﯾدار

ﺪﻨﺟﺮﯿﺑ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽﻤﻠﻋ ﻪﻠﺠﻣ .

1393

؛ 21 ) 3 :(

469 - 474 .

ﺖﻓﺎﯾرد : 03 / 09 / 1393 شﺮﯾﺬﭘ : 12 / 11 / 1393

شﻮﮔ هوﺮﮔ ،رﺎﯾدﺎﺘﺳا1

، ﻖﻠﺣ و هﺎﮕﺸﻧاد ،ﯽﮑﺷﺰﭘ هﺪﮑﺸﻧاد ،ﯽﻨﯿﺑ مﻮﻠﻋ

ﯽﮑﺷﺰﭘ ﻨﺟﺮﯿﺑ ﺪ

؛ناﺮﯾا ،ﺪﻨﺟﺮﯿﺑ ،

هﺎﮕﺸﻧاد ،ﯽﮑﺷﺰﭘ هﺪﮑﺸﻧاد ،ﯽﺷﻮﻬﯿﺑ هوﺮﮔ ،رﺎﯾدﺎﺘﺳا٢

مﻮﻠﻋ ﯽﮑﺷﺰﭘ

؛ناﺮﯾا ،ﺪﻨﺟﺮﯿﺑ ،ﺪﻨﺟﺮﯿﺑ

؛لوﺆﺴﻣ هﺪﻨﺴﯾﻮﻧ٣

هوﺮﮔ ،ﯽﺑﺮﻣ ﻞﻤﻋ قﺎﺗا ، ،ﯽﮑﺷﺰﭘاﺮﯿﭘ هﺪﮑﺸﻧاد هﺎﮕﺸﻧاد

مﻮﻠﻋ ﯽﮑﺷﺰﭘ ناﺮﯾا ،ﺪﻨﺟﺮﯿﺑ ،ﺪﻨﺟﺮﯿﺑ

سردآ : ﺪﻨﺟﺮﯿﺑ - يرﺎﻔﻏ نﺎﺑﺎﯿﺧ - د ،ﺪﻨﺟﺮﯿﺑ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد ﯽﮑﺷﺰﭘاﺮﯿﭘ هﺪﮑﺸﻧا

ﻦﻔﻠﺗ : 05618825450 ﺮﺑﺎﻤﻧ

: ﯽﮑﯿﻧوﺮﺘﮑﻟا ﺖﺴﭘ :

[email protected]

(2)

ﻪﻣﺪﻘﻣ

ياﺮﺑ ندﺮﮐاﺪﯿﭘ ﻢﺴﺟ

ﯽﺟرﺎﺧ

، ﻪﺘﺴﺑ ﻪﺑ ﺲﻨﺟ

،نآ ﯽﻣ ناﻮﺗ

زا شور يﺎﻫ ﯽﻔﻠﺘﺨﻣ هدﺎﻔﺘﺳا

دﺮﮐ . ياﺮﺑ مﺎﺴﺟا ﺐﺟﺎﺣ ﻪﺑ

ﻪﻌﺷا

، ﯽﻣ ناﻮﺗ زا ﯽﻓاﺮﮔﻮﯾدار ﯽﻟﻮﻤﻌﻣ

هدﺎﻔﺘﺳا دﺮﮐ ؛ ﯽﻟو ياﺮﺑ

ﯽﻣﺎﺴﺟا ﻪﮐ

ﻪﺑ ﻪﻌﺷا ﺐﺟﺎﺣ

،ﺪﻨﺘﺴﯿﻧ تﻼﮑﺸﻣ

ﯽﺼﯿﺨﺸﺗ

يﺮﺘﺸﯿﺑ دﻮﺟو دراد . تاﺮﻫﺎﻈﺗ ﻢﺴﺟ

ﯽﺟرﺎﺧ هﺪﻧﺎﻤﯿﻗﺎﺑ

، ﯽﻣ ﺪﻧاﻮﺗ

ﻪﺑ ترﻮﺻ هدﻮﺗ يﺎﻫ ﺖﻔﺳ ﺮﯿﻏ

ّﺮﺤﺘﻣ ك ﺎﯾ ﺳ سﻮﻨﯿ ﯽﺤﺷﺮﺗ و

ﺎﯾ ﻪﺴﺑآ ﺮﻫﺎﻈﺗ ﺪﯾﺎﻤﻧ . رد ﯽﺗرﻮﺻ ﻪﮐ ﻢﺴﺟ ﯽﺟرﺎﺧ ﻪﺑ ﻊﻗﻮﻣ

ﺺﯿﺨﺸﺗ هداد

دﻮﺷ

، ﻪﺑ ناﺰﯿﻣ يدﺎﯾز زا تﻼﮑﺸﻣ ﯽﺷﺎﻧ

زا

تﺎﻣاﺪﻗا ﺮﯿﻏ يروﺮﺿ ﯽﺼﯿﺨﺸﺗ

و ﯽﻧﺎﻣرد ياﺮﺑ رﺎﻤﯿﺑ ﺪﻫاﻮﺧ

ﺖﺳﺎﮐ ) 1

، 2 (.

رد يرﺎﻤﯿﺑ ﻪﮐ ﻪﻘﺑﺎﺳ دورو ﻢﺴﺟ ﯽﺟرﺎﺧ ﻪﺑ نﺪﺑ

ار ﺮﮐذ ﯽﻣ ﺪﻨﮐ

، ﻢﻬﻣ ﻦﯾﺮﺗ ﻪﺘﮑﻧ يا ﻪﮐ ﯾﺎﺑ ﺪ رد ﻦﻫذ ﮏﺷﺰﭘ

ﺞﻟﺎﻌﻣ ﺪﺷﺎﺑ

، ﻦﯾا ﺖﺳا ﻪﮐ ﻦﮑﻤﻣ ﺖﺳا ﻢﺴﺟ ﯽﺟرﺎﺧ

، ﻞﺧاد

نﺪﺑ هﺪﻧﺎﻣ ﺪﺷﺎﺑ . دﻮﺟو ،ﻪﻟﺎﻘﻣ ﻦﯾا رد ﮏﯾ

درﻮﻣ ﻢﺴﺟ ﯽﺟرﺎﺧ

6 ﯽﺘﻧﺎﺳ يﺮﺘﻣ شﻮﻣاﺮﻓ هﺪﺷ رد ﻪﻧﻮﮔ رﺎﻤﯿﺑ شراﺰﮔ ﯽﻣ ددﺮﮔ .

رﺎﻤﯿﺑ ﯽﻓﺮﻌﻣ

يﺮﺘﺧد رﺎﻤﯿﺑ 9

ﻪﻟﺎﺳ و ﺮﻬﺷ ﻦﮐﺎﺳ طﻮﻘﺳ ﻪﻘﺑﺎﺳ ﻪﮐ ﺖﺳا

ﮏﯾ عﺎﻔﺗرا زا يﺮﺘﻣ

ار ﯽﻟﺎﺣ رد و هدﻮﺑ ﺶﺘﺳد رد داﺪﻣ ﮏﯾ ﻪﮐ

مﺎﮕﻨﻫ رد طﻮﻘﺳ

، ﻪﻧﻮﮔ رد داﺪﻣ يو

و ﻪﺘﻓر وﺮﻓ ﻪﺘﺴﮑﺷ

،ﺖﺳا

ﯽﻣ ﺮﮐذ ﺪﻨﮐ . ﻪﻌﺟاﺮﻣ زا ﺲﭘ رﺎﻤﯿﺑ

ﺲﻧاژروا ﻪﺑ

، ﻪﻧﻮﮔ زا ﻪﮐ يو

هﺪﺷ ﻖﯿﻤﻋ ﻢﺧز و ﯽﮔرﺎﭘ رﺎﭼد دﻮﺑ

ه ﺪﻣآ ﻞﻤﻋ ﻪﺑ ﯽﻓاﺮﮔﻮﯾدار ، ه

ﺖﺳا ﻪﻧﻮﮔ رد ﯽﺟرﺎﺧ ﻢﺴﺟ زا يﺮﺛا ﯽﻓاﺮﮔ ﻦﯾا رد ﻪﮐ يو

ﺪﺸﻧ هﺪﻫﺎﺸﻣ ﺳا ه

ﺖ

؛ ﻪﺠﯿﺘﻧ رد

، ﯽﮔرﺎﭘ ﻞﺤﻣ هﺪﺷ هداد ﻮﺸﺘﺴﺷ

،

ﻪﯿﺨﺑ نﺎﻤﺴﻧﺎﭘ و

؛ﺖﺳا هﺪﯾدﺮﮔ ﺲﭙﺳ

دﺪﺠﻣ رﺎﻤﯿﺑ هﺪﺷ ﺖﯾﺰﯾو

ﯽﺘﻧآ ﯽﯾوراد رﻮﺘﺳد ﺎﺑ و ﺺﺧﺮﻣ ﮏﯿﺗﻮﯿﺑ

ﺖﺳا هﺪﺷ .

رﺎﻤﯿﺑ

، ﺪﻌﺑ

ﺺﯿﺧﺮﺗ زا

، ﻪﺑ رّﺮﮑﻣ رﻮﻃ و درد زا و هدﻮﻤﻧ ﻪﻌﺟاﺮﻣ ﮏﺷﺰﭘ ﻪﺑ

ﯽﻣ ﺖﯾﺎﮑﺷ ﻢﺧز ﻞﺤﻣ ﺢﺷﺮﺗ ﺪﻨﮐ

؛ ﻪﺑ يرﻮﻃ ﮏﯾ ﻪﮐ ﻢﺧز ﺰﯿﻧ رﺎﺑ

ﺑ دﺪﺠﻣ رﺎﻤﯿ تﺎﺤﺷﺮﺗ و هﺪﺷ زﺎﺑ

نآ و جرﺎﺧ ﻪﺑ رﻮﻃ ﻪﯿﺨﺑ دﺪﺠﻣ

هدز ﺖﺳا هﺪﺷ .

ﺗ ﺎﺑ ﺄ ﺖﺳﻮﭘ ﺮﯾز رد داﺪﻣ ﻪﮐ رﺎﻤﯿﺑ ﯽﻫاﺮﻤﻫ ﺪﯿﮐ

ﺖﺳا ﺲﻤﻟ ﻞﺑﺎﻗ رﺎﻤﯿﺑ

،

،رﺎﻤﯿﺑ ﻪﺑ رﻮﻃ

ﺪﺠﻣ يﺮﮕﯾد ﮏﺷﺰﭘ ﻪﺑ د

هدﺮﮐ ﻪﻌﺟاﺮﻣ ﺖﺳا

.

،ﮏﺷﺰﭘ ياﺮﺑ يو ﯽﺳ ﯽﺗ لاﺮﭙﺳا ﻦﮑﺳا

سﻮﻨﯿﺳ و ترﻮﺻ لازﺎﻧارﺎﭘ يﺎﻫ

ﺖﺳاﻮﺧرد هدﺮﮐ

ﻪﮐ د ر

ﯽﺳ ﯽﺗ ﻦﮑﺳا

، ﺴﻧاد ﮏﯾ ﺮﯾﻮﺼﺗ رﻻﻮﺑﻮﺗ ﯽﺟرﺎﺧ ﻢﺴﺟ ﻪﺘﯿ

ﻪﺑ لﻮﻃ 60 ﯽﻠﯿﻣ سﻮﻨﯿﺳ ﯽﻧﺎﺘﺤﺗ مﺮﻧ ﺞﺴﻧ ﺮﯿﺴﻣ رد ﺮﺘﻣ

هﺪﻫﺎﺸﻣ ﺖﺳار يرﻼﯾﺰﮔﺎﻣ ﯽﻣ

دﻮﺷ سﻮﻨﯿﺳ ﻞﺧاد ﻪﺑ ﻪﮐ

لازﺎﻧ مﻮﺘﭙﺳ تازﺎﺤﻣ ﺎﺗ ﺖﺳار لازﺎﻧ ﻪﺘﯾوﺎﮐ و يرﻼﯾﺰﮔﺎﻣ ﺖﺳا هدﺮﮐ اﺪﯿﭘ شﺮﺘﺴﮔ .

ﻊﯾﺎﻣ سﻮﻨﯿﺳ ﻞﺧاد رد ادوﺰﮔا

ﺖﺳار يرﻼﯾﺰﮔﺎﻣ دﻮﺑ دﻮﻬﺸﻣ ﺰﯿﻧ

ﺖﺳا ه . ﺺﯿﺨﺸﺗ زا ﺪﻌﺑ

،

رﺎﻤﯿﺑ داﺪﻣ و ﻪﺘﻓﺮﮔ راﺮﻗ ﺖﺳار كﻻوﺪﻟﺎﮐ ﯽﺣاﺮﺟ ﻞﻤﻋ ﺖﺤﺗ

ﻪﺘﺴﮑﺷ ﺘﺷاد راﺮﻗ رﺎﻤﯿﺑ ﻪﻧﻮﮔ رد ﻪﮐ يا

،ﻪ ﺪﯾدﺮﮔ جرﺎﺧ ﺖﺳا ه

.

ﻪﮐ ﺖﺳا ﺮﮐذ ﻪﺑ مزﻻ عﻮﻗو نﺎﻣز زا

ﺳ ﺺﯿﺨﺸﺗ ﺎﺗ ﻪﺤﻧﺎ ﯽﻌﻄﻗ

،

ﮏﯾ دوﺪﺣ هﺪﯿﺸﮐ لﻮﻃ هﺎﻣ

هدﻮﺑ ﺖﺳا .

(3)

ﻞﮑﺷ 2 - ﯽﺳ نﻼﭘ رد داﺪﻣ ﺮﯾوﺎﺼﺗ ﯽﺗ

.ﻦﮑﺳا ﻒﻟا ( رد لﺎﮐﻮﺑ يﺎﻀﻓ رد داﺪﻣ ﺮﯾﻮﺼﺗ شﺮﺑ

رﻼﯾﺰﮔآ . ب ( سﻮﻨﯿﺳ رد داﺪﻣ ﺮﯾﻮﺼﺗ

رد رﻼﯾﺰﮔﺎﻣ شﺮﺑ

رﻼﯾﺰﮔآ . ج ( رد داﺪﻣ ﺮﯾﻮﺼﺗ

،لﺎﮐﻮﺑ يﺎﻀﻓ خارﻮﺳ

نﺪﺷ دراو و ﻪﺑ نﺪﺷ و رﻼﯾﺰﮔﺎﻣ سﻮﻨﯿﺳ ﺪﯿﺋﻮﻤﺗا

رد شﺮﺑ لﺎﻧوﺮﮐ . د (

ﺎﻀﻓ رد داﺪﻣ ﺮﯾﻮﺼﺗ رﻼﯾﺰﮔﺎﻣ سﻮﻨﯿﺳ و لﺎﮐﻮﺑ ي

ﺪﯿﺋﻮﻤﺗا و رد شﺮﺑ لﺎﺘﯾژﺎﺳ

هرﺎﻤﺷ ﻞﮑﺷ 3

- ﻪﻧﻮﮔ رد داﺪﻣ ﺮﯾﻮﺼﺗ

ﻪﻧﻮﮔ زا هﺪﺷ جرﺎﺧ داﺪﻣ ﺮﯾﻮﺼﺗ- 4 هرﺎﻤﺷ ﻞﮑﺷ

ﻒﻟا ب

ج

ب ﻒﻟا

د

(4)

ﺚﺤﺑ ﻞﻣﺎﺷ مﺮﻧ ﺖﻓﺎﺑ ﻪﺑ ﺎﻣوﺮﺗ :

خارﻮﺳ ﺖﺳد ﯽﮔرﺎﭘ و ﯽﮔﺪﺷ

ﯽﻗﺎﺑ ﺎﺑ ﻪﮐ ﺖﺳا ﯽﻣ هﺪﯿﭽﯿﭘ ﯽﺟرﺎﺧ ﻢﺴﺟ نﺪﻧﺎﻣ

دﻮﺷ . دﻮﺟو

ﯽﺟرﺎﺧ ﻢﺴﺟ ﯽﻣ ﯽﻫﺎﮔ مﺮﻧ ﺖﻓﺎﺑ رد

تﻼﮑﺸﻣ ﻪﺑ ﺮﺠﻨﻣ ﺪﻧاﻮﺗ

دﻮﺷ ﯽﻧﺎﻣرد و ﯽﺼﯿﺨﺸﺗ )

1 .(

ﻞﺤﻣ رد ﯽﺟرﺎﺧ ﻢﺴﺟ دﻮﺟو ﺎﺑ

،

ﺖﻧﻮﻔﻋ ﺮﻄﺧ

، اﺪﯿﭘ ﺶﯾاﺰﻓا نآ ﯽﮑﯿﻣﻮﺗﺎﻧآ ﻞﺤﻣ ﻪﺑ ﻪﺘﺴﺑ

ﯽﻣ ﺪﻨﮐ . ﻪﺑ ﯽﺟرﺎﺧ ﻢﺴﺟ ﺺﯿﺨﺸﺗ مﺪﻋ

ّﻠﻋ

ّﻗد مﺪﻋ ﺖ رد ﺖ

حﺮﺷ ﻦﺘﻓﺮﮔ لﺎﺣ

رﺎﻤﯿﺑ زا ﯽﻓاﺮﮔﻮﯾدار و ﻞﻣﺎﮐﺎﻧ ﯽﻨﯿﻟﺎﺑ تﺎﻨﯾﺎﻌﻣ ،

هاﺮﻤﮔ ﻨﮐ هﺪﻨ

، ﯽﻣ ﺗ ﺐﺒﺳ ﺪﻧاﻮﺗ ﺄ

ناﺰﯿﻣ ﺶﯾاﺰﻓا و ﺺﯿﺨﺸﺗ رد ﺮﯿﺧ

دﻮﺷ ضراﻮﻋ )

1 ، 2 .(

ﯽﺟرﺎﺧ مﺎﺴﺟا ندﺮﮐاﺪﯿﭘ ياﺮﺑ

، ﺎﻬﻧآ ﺲﻨﺟ ﻪﺑ ﻪﺘﺴﺑ

ﯽﻣ شور زا ناﻮﺗ دﺮﮐ هدﺎﻔﺘﺳا ﻒﻠﺘﺨﻣ يﺎﻫ

. هدﺎﺳ ﯽﻓاﺮﮔﻮﯾدار

،

ﻊﯾﺮﺳ ﺖﺳا ﺲﻧاژروا نارﺎﻤﯿﺑ ﯽﺑﺎﯾزرا رد شور ﻦﯾﺮﺗ ﻪﮐ

ياﺮﺑ

اﺟ ﻪﻌﺷا ﺐﺟﺎﺣ مﺎﺴ

، ﯽﻣ زا ناﻮﺗ نآ هدﺎﻔﺘﺳا دﺮﮐ ) ﺰﻠﻓ 100 % و

ﻪﺸﯿﺷ 93 % ﺖﺳا ﺺﯿﺨﺸﺗ ﻞﺑﺎﻗ (

؛ ا ياﺮﺑ ﯽﻟو ﻪﺑ ﻪﮐ ﯽﻣﺎﺴﺟ

،ﺪﻨﺘﺴﯿﻧ ﺐﺟﺎﺣ ﻪﻌﺷا ﻞﺜﻣ

: ﮏﯿﺘﺳﻼﭘ و بﻮﭼ

، تﻼﮑﺸﻣ

دراد دﻮﺟو يﺮﺘﺸﯿﺑ ﯽﺼﯿﺨﺸﺗ

؛ ﻪﺑ يرﻮﻃ هدﺎﺳ ﯽﻓاﺮﮔﻮﯾدار ﺎﺑ ﻪﮐ

ﻂﻘﻓ 15 % ﺪﻨﺘﺴﻫ ﺖﯾؤر ﻞﺑﺎﻗ ﯽﺑﻮﭼ ﯽﺟرﺎﺧ مﺎﺴﺟا )

1 - 4 .(

ﯽﺑﻮﭼ ﯽﺟرﺎﺧ مﺎﺴﺟا

، و ﯽﻓاﺮﮔﻮﻧﻮﺳ زا هدﺎﻔﺘﺳا ﺎﺑ CT SCAN

ﺪﻨﺘﺴﻫ ﺺﯿﺨﺸﺗ ﻞﺑﺎﻗ )

5 .(

ﯽﻓاﺮﮔﻮﻧﻮﺳ ،

و MRI CT SCAN

، ﻪﺑ شور ناﻮﻨﻋ ﯽﯾﺎﻫ

ﺖﻓﺎﺑ رد ﯽﺟرﺎﺧ مﺎﺴﺟا يﻮﺠﺘﺴﺟ ياﺮﺑ هﺪﺷ نﺎﯿﺑ مﺮﻧ يﺎﻫ

ﺪﻧا .

و MRI CT SCAN

، دراﻮﻣ ﻦﯾا رد ود ﺮﻫ

، ﯽﻓاﺮﮔﻮﻧﻮﺳ زا

سﺎﺴﺣ ﺪﻧﺮﺗ )2 - 6 ، 7(

. ﺪﻧﻮﺳاﺮﺘﻟوا

،

ّﺛﺆﻣ زا ﯽﮑﯾ شور ﻦﯾﺮﺗﺮ

ﺎﻫ

ﻓﺎﺑ ﯽﺟرﺎﺧ مﺎﺴﺟا ﺺﯿﺨﺸﺗ رد ﺖﺳا ﺲﻧاژروا ﺶﺨﺑ رد مﺮﻧ ﺖ

هدﺎﻔﺘﺳا ﻪﮐ لﻮﻤﻌﻣ

يژﻮﻟﻮﻨﮑﺗ ﻦﯾا زا

، ﯽﺟرﺎﺧ مﺎﺴﺟا زا

شﻮﻣاﺮﻓ هﺪﺷ دﺮﮐ ﺪﻫاﻮﺧ يﺮﯿﮕﺸﯿﭘ نآ ضراﻮﻋ و .

ﯽﻓاﺮﮔﻮﻧﻮﺳ

ًﺎﺒﯾﺮﻘﺗ ﺖﺳا ردﺎﻗ ﺪﻫد نﺎﺸﻧ ار ﯽﺟرﺎﺧ مﺎﺴﺟا ﻪﻤﻫ

.

ﯿﺳﺎﺴﺣ ﺖ

ﻪﺑ نآ ﯽﺟرﺎﺧ مﺎﺴﺟا ﻪﻤﻫ 94

ﺎﺗ 98 % ﺖﺳا هﺪﺷ شراﺰﮔ .

اﺮﮔﻮﻧﻮﺳ ﺎﺑ ود ﺮﻫ ﮏﯿﺘﺳﻼﭘ و بﻮﭼ ﯽﻓاﺮﮔﻮﯾدار زا ﺮﺘﻬﺑ ﯽﻓ

ﯽﻟﻮﻤﻌﻣ

، ﯽﻣ ﺖﯾؤر ﺪﻧﻮﺷ

. هداد نﺎﺸﻧ تﺎﻌﻟﺎﻄﻣ مﺎﺴﺟا ﻪﮐ ﺪﻧا

زا ﺮﺘﻤﮐ ﯽﺑﻮﭼ ﯽﺟرﺎﺧ 5/

2 ﯽﻠﯿﻣ رد ﺪﻧﻮﺳاﺮﺘﻟوا رد ﺮﺘﻣ 92

%

هﺪﺷ هﺪﯾد دراﻮﻣ ﺪﻧا

؛ زا ﺮﺘﻤﮐ ءﺎﯿﺷا 10

ﯽﻠﯿﻣ ﻪﺑ ﺮﺘﻣ ﻂﺳﻮﺗ ﯽﺘﺣار

،ﯽﻓاﺮﮔﻮﻧﻮﺳ و MRI

CT SCAN ر ﻞﺑﺎﻗ

ؤ ﺪﻨﺘﺴﻫ ﺖﯾ )

1 - 8 ،

10 ( . Dumsrey ارﺎﮑﻤﻫ و

ن

، ﯽﻧارﺎﻤﯿﺑ رد ار ﯽﻓاﺮﮔﻮﻧﻮﺳ مﺎﺠﻧا

ﺐﯿﺳآ ﻪﮐ ﺪﻧراد ﯽﺟرﺎﺧ مﺎﺴﺟا ﺎﺑ يذﻮﻔﻧ يﺎﻫ

، ﻪﺑ

ّﻠﻋ

ﯿﺳﺎﺴﺣ ﺖ ﺖ

ﯽﻣ يرﺎﺒﺟا نآ يﻻﺎﺑ ﺪﻨﻧاد

) 8 .(

شور بذﺎﮐ ﯽﻔﻨﻣ و بذﺎﮐ ﺖﺒﺜﻣ باﻮﺟ ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ يﺎﻫ

ماﺪﻗا ،يرادﺮﺑﺮﯾﻮﺼﺗ يژﻮﻟﻮﯾدار شراﺰﮔ سﺎﺳا ﺮﺑ ﻂﻘﻓ ندﺮﮐ

ﯽﻣ ﻪﺑ ﺮﺠﻨﻣ ﺪﻧاﻮﺗ زوﺮﺑ

دﻮﺷ ﯽﺗﻼﮑﺸﻣ )

2 .(

ﯽﺘﺣ وMRI

،MRI ﺎﺑ ﯽﻣ ﻖﯾرﺰﺗ هدﻮﺗ قاﺮﺘﻓا رد ﺪﻧاﻮﺗ

ﺎﻫ

ماﺪﻧا رد ﻪﺑ ﺎﻫ ﻪﭽﺑ رد صﻮﺼﺧ و ﯽﮑﯿﻨﯿﻠﮐ ﺮﻈﻧ زا ﻪﮐ ﺎﻫ

ﺪﻧراﺪﻧ ﯽﻬﺟﻮﺗ ﻞﺑﺎﻗ تﺎﮑﻧ ﯽﮑﯿﻨﯿﻠﮐارﺎﭘ

،

در رد ﻢﺴﺟ ﺺﯿﺨﺸﺗ

ّﺛﺆﻣ ﯽﺟرﺎﺧ ﺪﺷﺎﺑ ﺮ

؛ زا هدﺎﻔﺘﺳا ﺎﺑ ﯽﺘﺣ ﯽﻟو ﺎﯾ و MRI

رد و ﺪﺷﺎﺑ ﻞﮑﺸﻣ ﺖﺳا ﻦﮑﻤﻣ ﺢﯿﺤﺻ ﺺﯿﺨﺸﺗ ،ﯽﻓاﺮﮔﻮﻧﻮﺳ ﻮﺻ ﻦﯾا تر

، ﯽﻣ ﮏﺷﺰﭘ ﻪﺑﺮﺠﺗ و ﯽﻨﯿﻟﺎﺑ ﻢﺋﻼﻋ ﻖﯿﺒﻄﺗ ﺪﻧاﻮﺗ

ﮏﻤﮐ ﺪﺷﺎﺑ هﺪﻨﻨﮐ .

ﻪﺠﯿﺘﻧ يﺮﯿﮔ ﻪﯿﻟوا ﯽﮑﯾﺰﯿﻓ تﺎﻨﯾﺎﻌﻣ و رﺎﻤﯿﺑ لﺎﺣ حﺮﺷ ،نارﺎﻤﯿﺑ ﺎﺑ درﻮﺧﺮﺑ رد

،

ﺢﯿﺤﺻ ﺺﯿﺨﺸﺗ ﻪﺑ ار ﮏﺷﺰﭘ ﻪﮐ ﺪﻨﺘﺴﻫ ﯽﻠﻣاﻮﻋ ﻦﯾﺮﺘﻤﻬﻣ ﯽﻣ ﺎﺳر ﻧ موﺰﻟ ترﻮﺻ رد و ﺪﻨ

، ﯽﺳ مﺎﺠﻧا ﯽﺗ

يدﺎﯾز ﮏﻤﮐ ﻦﮑﺳا

ﺨﺸﺗ ﻪﺑ ﯿ ﺺ اﯾ ﻦ ﻫاﻮﺧ دراﻮﻣ ﺪ

دﻮﻤﻧ .

ﯾﺪﻘﺗ ﺮﮑﺸﺗ و ﺮ

ﻦﯾﺪﺑ زا ﻪﻠﯿﺳو هﺎﮕﺸﻧاد يروﺎﻨﻓ و تﺎﻘﯿﻘﺤﺗ ﺖﻧوﺎﻌﻣ

و

ﻦﯿﻨﭽﻤﻫ نﺎﺘﺳرﺎﻤﯿﺑ ﯽﻨﯿﻟﺎﺑ تﺎﻘﯿﻘﺤﺗ ﻪﻌﺳﻮﺗ ﺰﮐﺮﻣ يرﺎﮑﻤﻫ

ﻟو ﯿ ﺮﺼﻌ ﺑﯿ ﺪﻨﺟﺮ ﯽﻣ ﯽﻧادرﺪﻗ و ﺮﮑﺸﺗ ﻪﻧﺎﻤﯿﻤﺻ ددﺮﮔ

.

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ﻊﺑﺎﻨﻣ :

1- Budhram GR, Schmunk JC. Bedside ultrasound AIDS identification and removal of cutaneous foreign bodies: a case series. J Emerg Med. 2014;47(2):e43-8.

2- Fakoor M. A case of foreign body in leg with tumor-like presentation on MRI. Ahwaz Jondi Shapur University Of Medical Sciences Scientific Medical Journal; 2006; 5(2): 543-5. [Persian]

3- Anderson MA, Newmeyer WL 3rd, Kilgore ES Jr. Diagnosis and treatment of retained foreign bodies in the hand.

Am J Surg. 1982; 144(1): 63-7.

4- Horton LK, Jacobson JA, Powell A, Fessell DP, Hayes CW. Sonography and radiography of soft-tissue foreign bodies. AJR Am J Roentgenol. 2001; 176(5): 1155-9.

5- Oikarinen KS, Nieminen TM, Makarainen H, Pythtinen J. Visibility of foreign bodies in soft tissue in plain radiographs, computed tomography, magnetic resonance imaging and ultrasound: An in vitrostudy. Int J Oral Maxillofac Surg. 1993; 22(2): 119-24.

6- Hung YT, Hung LK, Griffith JF, Wong CH, Ho PC. Ultrasound for the detection of vegetative foreign body in hand-- a case report. Hand Surg. 2004; 9(1): 83-7.

7- Levy AD, Harcke HT. Handheld ultrasound device for detection of non-opaque and semi-opaque foreign bodies in soft tissues. J Clin Ultrasound. 2003; 31(4): 183-8.

8- Dumarey A, De Maeseneer M, Ernest C. Large wooden foreign body in the hand: recognition of occult fragments with ultrasound. Emerg Radiol. 2004; 10(6): 337-9.

9- Blankstein A, Cohen I, Heiman Z, Salai M, Heim M, Chechick A. Localization, detection and guided removal of soft tissue in the hands using sonography. Arch Orthop Trauma Surg. 2000; 120(9): 514-7.

10- Mizel MS, Steinmetz ND, Trepman E. Detection of wooden foreign bodies in muscle tissue: experimental comparison of computed tomography, magnetic resonance imaging, and ultrasonography. Foot Ankle Int. 1994; 15(8):

437-43.

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Abstract Case Report

A case report of a 6-cm-long missed foreign body in the cheek of a patient

Mohammadreza Mofatteh¹, Malihe Zangoue², Maryam Tolyat³

Lack of attention to a patient’s history and his/her accurate physical examination may lead to diagnostic and treatment problems.

Thus, a case is reported in which a missed foreign body inside a patient’s cheek caused therapeutic problems The patient was a nine-year old girl who had a broken pencil lead inside one of her cheeks due to falling off a height of one-meter, while she had been holding the pencil in her hand. She was referred to EMS;

radiography was taken from the laceration, and it was sutured. She was discharged with antibiotic medication. After discharge, the patient repeatedly referred to physicians and complained of pain and secretion in the sutured area. At the end, spiral CT scan of paranasal sinuses was demanded which depicted a 60 mm tubular foreign body. Thus, the patient had to undergo surgery.

In visiting patients their primary histories and physical examinations are the most decisive factors which help physicians to make proper diagnoses.

If necessary, CT scans can be of great tool for diagnosis.

Key Words: Foreign body; Soft tissue; Radiography

Journal of Birjand University of Medical Sciences. 2015; 21 (4): 469-474.

Received: November 24, 2014 Accepted: February 1, 2015

1 Assistant professor, Department of ENT, Faculty of Medicine, Birjand University of Medical Science, Birjand, Iran;