A CASE OF NEOPLASM-CAUSED INTESTINAL OBSTRUCTION INDUCED BY PERSIMMON SEEDS

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  • 柿の種子が誘因となって発症した大腸癌イレウスの１例

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Abstract

An 82-year-old man seen at the hospital because of abdominal distention and abdominal pain was suspected to have dietary intestinal obstruction based on his history of laparotomies as well as questioning of the patient. Following his admission to the hospital, conservative therapy was started. Abdominal CT findings and elevated tumor markers indicated a diagnosis of intestinal obstruction caused by advanced colorectal cancer associated with hepatic metastasis, and the patient was operated on. Upon laparotomy a tumor about 4cm in diameter was palpated at the cecum in the vicinity of ileocecal valve and another was found at a portion slightly proximal to the ascending colon. A right hemicolectomy with D2 lymph node dissection was carried out. Following an examination of the excised material, a tumor encircling the entire lumen of the ascending colon and five persimmon seeds in the cecum were identified. The patient's postoperative course was uneventful. The patient was discharged from the hospital 26 days after the operation.<br> A persimmon seed is visualized as an area of hyper absorption on a CT scan and appears as crescent or oval in shape. This case was of neoplasm-caused intestinal obstruction induced by persimmon seeds. Although there have been few cases of intestinal obstruction due to a tumor induced by foods in this country, persimmon seeds can cause intestinal obstruction. Therefore, detailed and careful questioning of the patient as well as a CT scan is considered helpful for reaching the correct diagnosis.

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