消化管異物による閉塞性イレウスの臨床的検討

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  • CLINICAL STUDIES OF OBSTRUCTIVE ILEUS DUE TO A FOREIGN BODY IN THE INTESTINE

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A forign body in the intestine requires surgical treatment only when 1) there is intestinal obstruction due to the foreign body, 2) there is intestinal perforation due to the foreign body and 3) the foreign body may produce a poisonous substance. Seven cases of obstructive ileus due to foreign bodies (ingested foreign bodies: 5, persimmon bezoar: 1, fecaloma: 1) were terated surgically and analyzed clinically.<br> In our cases, 80% of ileus due to ingested foreign bodies occurred at the ileum (within 1 m from ileal valve). Thus, it was considered that the foreign bodies were likely to be incarcerated in the ileum. Moreover, four of the seven patients (57.1%) had undergone laparotomy in the past. Thus, organic intestinal obstacles, such as adhesion and stenosis, are important factors relating to incarceration of foreign bodies in the intestine.<br> Preoperative diagnosis was very difficult, and in many cases, laparotomy had been performed for appendicitis or ileus. This obstructive ileus due to foreign bodies is a blind point for surgical treatment.

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