ドレーン抜去孔への小腸嵌頓による絞扼性イレウスの１例

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  • A CASE OF STRANGULATED ILEUS DUE TO THE IMPACTED SMALL INTESTINE IN AN OPENING LEFT AFTER REMOVAL OF A DRAIN

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A 78-year-old woman underwent a sigmoidectomy for cancer of the sigmoid colon, followed by insertion of a duple drain (10mm in diameter) to the Douglas' pouch. When the drain was removed on the 5th postoperative day, abdominal pain, nausea, and vomiting developed about 6 hours later. A fistsized subcutaneous tumor was found at a portion where was identical with that from which the drain was removed, and there was tenderness there as well. Abdominal CT scan showed the small intestine prolapsed to the subcutaneous structure. Prolapsed and incarcerated small intestine from a portion through where the drain was inserted was diagnosed, and an emergency operation was performed. During surgery we identified the impacted and necrotized small intestine in the opening left after removal of the drain and performed resection of the small intestine. The postoperative course was uneventful. The patient was discharged from the hospital on the 15th hospital day after the initial operation.

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