多発柿胃石による腸閉塞の１例

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  • A CASE OF MULTIPLE PERSIMMON STONES IN THE STOMACH CAUSING ILEUS

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We experienced a case of ileus caused by multiple persimmon gastric stones in a patient who had previous gastric resection. An 82-year-old, female patient who had previous gastric resection due to duodenal ulcer, came to our hospital with a complaint of sudden onset of abdominal pain and vomiting. An oval black foreign body, 4cm in size, was found in her stomach by a gastroscopic study. Even after removal of the foreign body crushed into small pieces, the above mentioned symptoms persisted. Therefore, a CT study was done which revealed a mass with heterogeneous content at the distal end of the dilated jejunum. A diagnosis of ileus due to a translocated gastric stone was made and an operation was performed. A stone was found in the jejunum 200cm distal from the ligament of Treitz. The stone was removed through an incision made on jejunal wall. The gastric stone removed was oval shaped and black in color, 3.0cm in size composed of tannic acid in 98%, and diagnosed as persimmon gastric stone. The cause of gastric stone is believed to be due to over ingestion of persimmon with delayed excretion from the stomach, especially after gastrectomy. A careful management of diet and administration of proper medications is thought to be helpful. Occasionally it is difficult to make correct dignosis. A detailed chech of the dietary habit of the patient is very important.

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