| Autor: |
(Keigo Oshiro), 大城 恵吾, (Ken Okai), 岡井 研, (Hajime Yoshii), 吉井 元, (Kazuto Ohara), 大原 和人, (Akira Yamada), 山田 哲, (Akimitsu Tadauchi), 多々内 暁光 |
| Zdroj: |
Journal of Japanese Association for Acute Medicine; October 2021, Vol. 32 Issue: 10 p517-522, 6p |
| Abstrakt: |
症例は78歳の男性。腹痛と嘔吐を主訴に前医受診し大腸イレウスを指摘され，当科へ紹介となった。CTでは完全内臓逆位を認め，横行結腸に高吸収を呈する糞便（約75×45×55mm）が貯留し, 口側結腸に拡張を認め, 脾湾曲付近の横行結腸に糞石が嵌頓しており糞便性イレウスと診断した。緊急下部消化管内視鏡検査では閉塞性大腸炎を疑う所見を認め，嵌頓は解除できたが，糞石は除去できず経肛門イレウス管の留置を行った。血圧低下・血清乳酸値上昇があり敗血症性ショックであった。ショックから離脱した後，経肛門イレウス管を使用しコーラ溶解療法を実施したところ速やかに糞石が排泄された。コーラ溶解療法により治療した糞便性イレウスの1例を経験したので報告する。 The patient was a 78–year–old man. He had visited a previous doctor with abdominal pain and vomiting. He was referred to our hospital for further examination and treatment. Computed tomography (CT) showed feces accumulated in the transverse colon, and dilation of the oral colon, so fecal ileus and obstructive colitis was diagnosed. We diagnosed septic shock because the average blood pressure was low and the lactate level was high. The fecaliths could not be removed by colonoscopy, and a transanal ileus tube was placed. After recovering from sepsis, following administration of Cola dissolution therapy via the transanal ileus tube, the fecaliths were rapidly excreted and healed completely. We report on a case of obstructive colitis treated with Cola dissolution therapy administered via a transanal ileus tube. |
| Databáze: |
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