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A case of multiple colon enterolith caused by taking a magnesium oxide laxative

山口医学 Volume 62 Issue 1 Page 55-59
published_at 2013-02-01
B030062000109.pdf
[fulltext] 1.76 MB
Title
酸化マグネシウム製剤服用による大腸多発腸石の一例
A case of multiple colon enterolith caused by taking a magnesium oxide laxative
Creators Kawano Michitaka
Creators Shirai Yasuyuki
Creators Matsunaga Kazuhito
Creators Shirasawa Tomohiro
Creators Matsunaga Takaharu
Creators Yokoyama Yuuichirou
Creators Nohara Hiroaki
Creators Kondou Satoshi
Creators Shingai Yasushi
Creators Saitou Mitsuru
Source Identifiers
Creator Keywords
酸化マグネシウム 腸石
真性腸石の本邦報告例は少数に過ぎない.酸化マグネシウム製剤の長期内服により大腸内多発腸石を来した稀な1例を報告する.症例は70歳代,女性.腰椎圧迫骨折,尿路感染症で入院したが,入院中に脳梗塞を発症し寝たきりとなった.便秘に対して酸化マグネシウム製剤を開始した約3年後に腹部膨満が悪化した.腹部CTで大腸内に多発する1cm大の石灰化を有する構造物を認め,下部消化管内視鏡検査では大腸内に多発する黄白色の腸石を認めた.結石分析検査で炭酸マグネシウム結石が疑われたため,酸化マグネシウム製剤の長期投与により形成された腸石を疑い,酸化マグネシウム製剤の中止と排便コントロールを行い,2週間後の腹部CTで腸石は消失した.これまでの真性腸石の本邦報告例では狭窄,憩室などの器質的因子が明らかであることが多いが,本症例では明らかな器質的因子はなく,寝たきりの状態による腸管運動機能の低下や腸管拡張が停滞因子となり腸石形成に関与したと考えられた.
We have reported a rare case in which long-term oral administration of a magnesium oxide caused the development of multiple enteroliths inside the colon. The patient was a 70-year-old woman. She became confined to the bed after developing a cerebral infarction while being hospitalized for a compression fracture and a urinary infection. She had experienced abdominal distension 3 years after starting a treatment using a magnesium oxide for constipation. Abdominal computed tomography revealed the presence of multiple structured objects inside the colon. Lower gastrointestinal endoscopy showed the presence of multiple enteroliths. On the basis of analytical test results, the enteroliths were suspected to be composed of magnesium carbonate. The administration of the magnesium oxide was discontinued, and defecation control was performed;Computed tomography performed 2 weeks later showed that the enteroliths had disappeared. Most cases of true enterolith reported in Japan have been found to be associated with organic factors such as stenosis or diverticula of the colon. However, our patient showed no apparent organic factors. Instead, the stagnation was believed to have been caused by factors such as bowel distention and decreased intestinal movements due to bed confinement, and this might have contributed to the formation of the enteroliths.
Subjects
医学 ( Other)
Languages jpn
Resource Type journal article
Publishers 山口大学医学会
Date Issued 2013-02-01
File Version Version of Record
Access Rights open access
Relations
[ISSN]0513-1731
[NCID]AN00243156
Schools 医学部