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Permalink : https://petit.lib.yamaguchi-u.ac.jp/3965
山口医学 Volume 55 Issue 4
published_at 2006-08-31
Preoperatively diagnosed bezoar-induced intestinal obstruction in a gastrectomized patient
術前診断が可能であった残胃胃石による小腸閉塞の1手術例
Oka Kazuhito
Seyama Atsushi
Kurazumi Hiroshi
Takemoto Yoshihiro
Inokuchi Toshihiro
Morita Tomoaki
About This Article
Descriptions
症例は91歳男性.約30年前に胃潰瘍で幽門側胃切除術,Billlroth II法再建術を施行された既往がある.平成15年12月便秘を主訴に来院し,精査加療目的で当院入院となった.小腸透視で胃空腸吻合部より約100cm肛門側の空腸に楕円形の透亮像,CTで含気を有する腫痛像を,腹部エコーで音響陰影を伴う腫瘤影が認められ,残胃胃石による小腸閉塞と診断された.手術は腹腔鏡下に開始したが癒着が高度であったため開腹術に移行した.胃空腸吻合部より約70cm肛門側に結石を触知し,結石を含む15cmの小腸を切除した.5.5×3.9cm大の結石で,小腸粘膜面には潰瘍が形成されていた.結石成分は98%以上がタンニンであった.胃石による小腸閉塞は腸管穿孔の危険性もあり,早期診断による外科手術が重要である.
Creator Keywords
残胃胃石
小腸閉塞
術前診断
Rights
本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである