A CASE OF INTRA-ABDOMINAL FOREIGN-BODY GRANULOMA PRESENTED WITH STRANGULATED ILEUS 59 YEARS AFTER SURGERY

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  • 術後５９年目に絞扼性イレウスで発症した腹腔内異物肉芽腫の１例

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Abstract

A 79-year-old woman, who had previous histories of ovarian adhesion and appendectomy at the age of 20, was seen at the hospital because of lower abdominal pain and vomiting after a supper. There were abdominal distention and tenderness mainly in the lower abdomen. Based on abdominal CT findings, strangulated ileus associated with an intra-abdominal tumor in the right lower abdomen was diagnosed, and an emergency surgery was performed on the same day. Surgical findings included that the small intestine was twisted and strangulated at the adhesion between the mesentery of small intestine and the tumor as the base. Histopathologically the tumor was intra-abdominal foreign-body granuloma due to gauze.<br> Although it is believed that ultrasonography, CT and magnetic resonance imaging are useful for making the diagnosis of foreign-body granuloma, sometimes we have difficulties in making the diagnosis because few cases present typical imaging findings. In addition we must be careful that the disease is asymptomatic in some cases, and can rarely cause septicemia, ileus, and intestinal perforation. In this case, foreign-body granuloma presented with strangulated ileus after a lapse of 59 years following surgery. This case, which recorded the longest interval from surgery to the onset of the disease in Japan as far as we could review, is reported here together with some bibliographical comments.

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