A CASE OF MULTIPLE PERFORATION OF THE COLON DUE TO PICA OF DEMENTED SENIUM

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  • 痴呆老人の異食による結腸多発穿孔の1例

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Abstract

An 81-year-old woman who was suffering from dementia since one year before was admitted to the hospital because of abdominal pain lasting for 10 days and increasing abdominal distension. The abdomen showed remarkable muscular defense. Plain abdominal X-ray film and abdominal CT scan showed intraabdominal free air. With a diagnosis of perforation of the digestive tract, and emergency laparotomy was performed. Turbid ascites was present in the abdominal cavity and foreign body caused multiple perforation from the descending to sigmoid colons. For these findings, left colectomy, lavage, drainage and transverse colostomy were carried out. It was found that vinyl cords filled the resected colon. Later it became clear that the patient had eaten Goza made of vinyl cords under the impression it was buckwheat noodles. Pica is a symptom of dementia. Therefore, it may be necessary to entertain the possible diagnosis of pica in the treatment for abdominal pain in demented senium.

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