乳糜腹水を伴った絞扼性イレウスの1例 [in Japanese] A CASE OF STRANGULATED ILEUS ACCOMPANIED WITH CHYLE-LIKE ASCITES [in Japanese]
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A 64-year-old man consulted a clinic in his neighborhood because of nausea and a gradually aggravating abdominal pain. He was diagnosed strangulated ileus and was referred to our hospital. Upon arrival, his level of consciousness was normal but the whole abdomen was swollen and pressure pain was recognized in the left flank. Abdominal CT revealed a large amount of ascites from the periphery of the liver to the vesicorectal fossa. Furthermore, there was about 180 degree torsion of the mesentery with the superior mesenteric artery as the axis, which led to the diagnosis of strangulated ileus. Accordingly, an emergency operation was performed on the same day. When we opened the abdomen we found a large volume (ca. 1000mL) of chyle-like ascites, and about 180 degree torsion of the mesentery in the clockwise direction with the superior mesenteric artery as the axis. The small intestine was pale purple and chyle-like fluid retention was observed in the small intestine mesentery. After the torsion was freed, the color of small intestine rapidly improved and the retention of chyle-like fluid in the mesentery tended to decrease. The post-operative course was favorable and the patient was discharged 10 days after the onset of symptoms.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 69(7), 1683-1686, 2008-07-25
Japan Surgical Association