Episode Transcript
Interviewer: 严重到需要去急诊室吗? Find out now. This is "E.R. or Not?" on The Scope. Time for another episode of "E.R. or Not?在大发娱乐，你可以决定是否应该去E.R. and then we'll find out the definitive answer from Dr. 大发娱乐急诊医学的特洛伊·马德森说. Today's E.R. or not, 很多人喜欢把牙签挂在嘴里, old ranchers, truck drivers, what happens if you swallow a toothpick? E.R. or not?
Dr. Madsen: I would say E.R.
Interviewer: Really?
Dr. Madsen: 这样做的原因是你可以把这类事情分为两类, 所以大发娱乐说的是你不小心吞下的东西, 在某些情况下，我看到这些东西被故意吞下，但这是完全不同的问题.
Interviewer: Okay.
Dr. Madsen: 但要么这些东西太大，无法通过你的肠道, 或者它们会很锋利，可能会刺穿肠道.
Interviewer: Okay.
Dr. Madsen: Both of those are problems.
Interviewer: Okay.
Dr. Madsen: 所以如果是太大的东西显然这不是牙签的问题, this isn't something that is really big, it should be able to pass without any issues, but the issue is that it's very sharp, so if we're talking about sharp things, 你知道，大发娱乐在孩子身上看到的最臭名昭著的事情之一就是缝纫针, so kind of think of a toothpick like a sewing needle. Then you think of the intestines, 一旦它通过了胃，它就会通过肠子，肠子很长，要走很长一段路, and they're very thin, 所以如果它是锋利的东西它可能会碰到边缘并穿过它并穿孔.
Interviewer: Really.
Dr. Madsen: 这是一个问题，因为你的肠道里有各种各样的细菌. 当细菌进入腹部的那一刻, 这可能是一件非常严重的事情，会导致一些非常严重的感染.
Interviewer: 所以现在很多时候，当你长时间咀嚼牙签后，牙签会开始变软, that wouldn't in your stomach get soft and dissolve away?
Dr. Madsen: Yeah, and again it's a tough one. This is really . . . you gave me a tough one here. You really made me think about this because you're right. 在不同的情况下，你可能会咀嚼牙签，可能会咬到它，在这种情况下，它可能会被咀嚼和浸渍，它会毫无问题地通过, 但如果你有一个锋利的物体，它会保持锋利, in your intestines and potentially perforate it, that's the problem. 所以我这么说的原因是可能值得来E.R., 当然，如果你说的是塑料牙签或任何更坚固的东西, that's not going to dissolve easily.
Interviewer: 是啊，他们现在有新的塑料牙签可以戳.
Dr. Madsen: 当然可以，所以我要说绝对可以. 木头的那个更像是灰色地带，但是我说，来E.R. because it's worth evaluating and talking to our G.I. 医生，大发娱乐的专家看看他们对此有什么看法.
Interviewer: Sure, because otherwise it could be serious.
Dr. Madsen: It could be and that's kind of weighing the risk benefit. It could potentially be a serious thing. If it's too long to pass, it's not going to go through, 以及大发娱乐认为太长或太宽的东西的方式, if it's longer than say about 5", 这是你吞下的铅笔，大发娱乐也见过有人吞下铅笔，他们是故意的，很有趣，这是不会过去的. And if it's wider than about 2", so it's something, maybe it's not 5" long but it's wider than 2", that's not going to pass, not going to get past the stomach.
Interviewer: What's the issue there then, if it gets stuck up in there?
Dr. Madsen: 所以如果它卡在胃里，没有东西能通过. 所以你会到达一个点，你喝的水可能最终都无法正常工作. The bottom line there is it's not going out, so it has to be something that has to come out from above, so you have to get a G.I. 医生带着瞄准镜下去，把那东西拿出来，从上面取出来.
Interviewer: Is that how a toothpick would be removed as well?
Dr. Madsen: It is.
Interviewer: 所以你不需要做手术，实际上它只是通过喉咙被移除?
Dr. Madsen: It is.
Interviewer: All right.
Dr. Madsen: 是的，它们会沿着食道进入胃，找到它，把它拉出来.
Interviewer: 如果我吞下了什么东西，它把东西堵住了，那是什么感觉?
Dr. Madsen: All right. So if you swallow something, you can feel it. And a lot of people will come in and . . . 大发娱乐看到的更多的是人们吞下一块肉而不完全咀嚼, 你只会感到喉咙充盈，很多时候人们都能准确地指出它在哪里. They can feel it upper throat, their lower throat or kind of down near the stomach, and often times they cannot swallow anything. 他们只会坐在那里，端着杯子吐着口水, as they cannot actually swallow it. If they try to it just comes right back up.
Interviewer: What if it makes it to the stomach and it's blocking that?
Dr. Madsen: 你通常不会有很多迹象，直到它相当进展. 所以我认为如果它堵塞了胃，你可能感觉不到. 你可能会觉得不舒服，但可能是在你开始吃东西之后，如果你已经吃了相当多的食物, you can just feel like it's just not moving anywhere, just like a rock in your stomach.
Interviewer: Would your body eventually throw up that food?
Dr. Madsen: Exactly. If you get enough in there, 它就会堆积起来，最终它就会被填满，然后它就会回来.
Interviewer: 所以经验法则，如果你吞下东西，宽度，长度，我要注意什么?
Dr. Madsen: So in terms of width and length, think longer than about 5" or wider than about 2", and that's kind of just a general rule of thumb. 如果是尖锐的东西可能会导致肠道穿孔, that's concerning as well. And certainly with these, if you're not sure what to do, err on the side of caution, 到急诊科来，然后大发娱乐可以大发娱乐你做出适当的决定，并让大发娱乐的专家也参与进来.