Okagawa Yutaka, Takada Kohichi, Sakamoto Hiroki, Miura Takumi, Abeshima Shigeki, Kato Junji
Department of Internal Medicine, Yakumo General Hospital.
Department of Medical Oncology, Sapporo Medical University School of Medicine.
Nihon Shokakibyo Gakkai Zasshi. 2017;114(6):1001-1007. doi: 10.11405/nisshoshi.114.1001.
An 87-year-old woman was admitted to our hospital for paralytic ileus, and she was treated using an ileus tube. Although her symptoms improved, abdominal fullness developed again on day 3 after ileus tube insertion. Abdominal computed tomography indicated intussusceptions at the ileum and the terminal part of the ileum;therefore, an emergency surgery was performed. During the surgery, antegrade intussusceptions were found in the ileum 60cm from the ileocecal valve and the terminal part of the ileum into the ascending colon. The intussusception of the anal side was resolved by manual reduction, but the oral side needed a partial resection of small bowel because of the presence of necrosis. There were no lesions, such as tumors, at the intussusceptions sites. Therefore, the two intussusceptions were thought to be caused by the ileus tube. We diagnosed a rare case of intussusceptions in the two parts of the ileum as a complication of the placement of an ileus tube.
一名87岁女性因麻痹性肠梗阻入院，接受了肠梗阻导管治疗。尽管她的症状有所改善，但在插入肠梗阻导管后的第3天，腹胀再次出现。腹部计算机断层扫描显示回肠和回肠末端发生套叠；因此，进行了急诊手术。手术中，在距回盲瓣60厘米处的回肠以及回肠末端至升结肠发现了顺行性套叠。肛门侧的套叠通过手法复位得以解决，但由于存在坏死，口腔侧需要进行小肠部分切除。套叠部位没有肿瘤等病变。因此，这两处套叠被认为是由肠梗阻导管引起的。我们诊断这例罕见的回肠两处套叠为肠梗阻导管放置的并发症。
