術前診断が可能で低侵襲手術（ＭＩＳ）を行った玉こんにゃくによる食餌性イレウスの１例

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  • A Case of Food-induced Ileus Caused by "TAMA-KONNYAKU" Diagnosed Preoperatively and Treated with Minimally Invasive Surgery

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A 74-year old female was urgently admitted to our hospital based on a diagnosis of ileus with the chief complaints of lower abdominal pain and nausea. She had swallowed “TAMA-KONNYAKU” (a paste made from the arum root) without chewing, two days before the symptoms developed. Abdominal X-ray examination and a CT scan revealed a generally expanded small intestine, filled with juice and gas. At first, conservative treatment with a naso-gastric tube was performed, followed by long-tube drainage on the fourth day. Emergency laparotomy was performed on the fifth day because ileal obstruction caused by the “TAMA-KONNYAKU” was diagnosed with small intestinal fluoroscopy. Minimally invasive surgery via a 5 cm mini-laparotomy was performed under spinal and epidural anesthesia in this patient as she had concomitant bronchial asthma. Furthermore, the pre-operative examination revealed that the intestinal obstruction was localized in the lower abdomen. During the operation, a bolus of “TAMA-KONNYAKU” measuring about 4×3×2cm was found causing the obstruction 10 cm proximal to Bauhin's valve, and was removed to resolve the ileus. The patient was discharged from the hospital on post-operative day 23. We report a case of food-induced ileus by the swallowing of “TAMA-KONNYAKU” diagnosed preoperatively and treated by minimally invasive surgery with a clinical study on food-induced ileus in the literature.

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