A Case of Sub Bowel Obstruction Caused by a Rectal Fecalith That Was Treated by Transanal Surgery with Cola Dissolution Therapy

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  • コーラ溶解療法を併用して経肛門的手術を行った直腸糞石による亜腸閉塞の1例
  • コーラ ヨウカイ リョウホウ オ ヘイヨウ シテ ケイコウモンテキ シュジュツ オ オコナッタ チョクチョウ フンセキ ニ ヨル アチョウ ヘイソク ノ 1レイ

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Abstract

<p>An 89-year-old man who had been admitted to a nursing care facility was brought to our hospital with a 3-days’ history of vomiting, abdominal distention, and difficulty in defecation. Abdominal computed tomography revealed a 55-mm fecalith in the lower rectum with calcification, and the patient was admitted to our hospital with a diagnosis of sub bowel obstruction caused by a rectal fecalith. We failed in our attempt at colonoscopic removal of the fecalith. Therefore, we undertook surgery to attempt transanal extraction of the fecalith. However, crushing of the fecalith with forceps proved impossible, and extraction of the fecalith in toto was difficult even with muscle relaxation. Finally, we injected Coca Cola transanally four times at intervals of 5 minutes (a total of 1,000 mL was injected), which softened the fecalith, and the fecalith was crushed with Magir forceps and extracted. In recent years, there have been some reports of the efficacy of cola dissolution therapy not only for bezoars, but also for enteroliths and fecaliths. We report a case in which transanal surgery combined with cola dissolution therapy was useful to extract a rectal fecalith.</p>

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