Iida Tomoya, Hirano Takehiro, Onodera Kei, Kubo Toshiyuki, Yamashita Kentaro, Yamano Hiroo, Nakase Hiroshi
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Minami 1-jo Nishi 16-chome, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan.
Clin J Gastroenterol. 2017 Aug;10(4):361-363. doi: 10.1007/s12328-017-0752-1. Epub 2017 Jun 6.
A 45-year-old woman visited our hospital complaining of abdominal pain 1 week after undergoing an annual medical checkup. Her vital signs and blood test results were normal, but tenderness was found in the lower abdomen. A high-density round structure found at the midline of the lower abdomen on an abdominal radiograph was thought to be an accumulation of barium (a barolith) from upper gastrointestinal barium radiography. Two liters of an oral gastrointestinal cleaning agent was administered, but defecation did not occur. Lower gastrointestinal endoscopy revealed that the barolith was impacted at the sigmoid colon. We unsuccessfully attempted to move it using a pressurized water jet and forceps, but it was too large to be captured by the net. Therefore, we broke it down using a snare. After a successful endoscopic procedure, 120 mL of a glycerin enema solution was injected through the forceps opening, causing the barolith to be excreted. There is only one similar case of successful endoscopic treatment of a barolith in the literature.
一名45岁女性在年度体检1周后因腹痛前来我院就诊。她的生命体征和血液检查结果均正常，但下腹部有压痛。腹部X光片显示下腹部中线处有一个高密度圆形结构，被认为是上消化道钡剂造影残留的钡剂积聚（钡石）。给予两升口服胃肠道清洗剂，但未排便。下消化道内镜检查显示钡石嵌顿在乙状结肠。我们试图用加压水枪和钳子移动它，但未成功，因为它太大，网兜无法捕获。因此，我们用圈套器将其破碎。内镜手术成功后，通过钳子开口注入120毫升甘油灌肠液，使钡石排出。文献中仅有一例类似的钡石内镜治疗成功病例。
