［症例報告］癒着性イレウスを契機に発見された胃石の1手術治験例

概要

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We report an operated case of a bezoar associated with adhesion ileus. A 83-year-old female visited to our hospital as because of repeated nausea and vomiting. Abdominal Xray showed slightly dilated small intestine contained gas. CT scan showed dilated small intestine and a mass in the stomach. Gastroscopic findings revealed a large size bezoar in the stomach. The decision for sursical treatment was undertaken for this patient due to presence of signs of ileus. Non invasive endoscopic therapy was not justified because of difficulty to remove a large mass and possibility of failure which might augmented worst condition of patient with ileus. Laparotomy was performed through the upper middie abdominal incision. We removed the bezoar (size:$5.5\times3.5cm$ , weight:450g) through an incision on gastric wall. We investigated whole small intestine from Treitz ligament to terminal ileum, but any sign of obstruction or presence of bezoar was not revealed. Analysis of the bezoar showed about 98% of tannic acid. Postoperative course was uneventful. The patient was recovered and discharged from the hospital 8 days after operation.
琉球医学会,Ryukyu Medical Associationの論文