落下胃石による小腸閉塞性イレウスの1例

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  • A CASE OF SMALL BOWEL OBSTRUCTION WITH A SPILLED BEZOAR

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We experienced a case of small bowel obstruction due to a spilled bezoar. A 70-year-old man was admitted to the hospital, because a X-ray film had revealed an elevated lesion of the stomach. Gastroscopy revealed a hen-egg sized bezoar with gastric ulcer. The bezoar did not be divided by biopsy forceps or snare. Because the patient did not accept the other endoscopic treatment of bezoar, the lesion was followed up conservatively. He did not complaint of any abdominal symptoms. However, he was hospitalized because of ileus state after 15 months. Gastroscopy did not reveal the bezoar. Emergency operation was performed under a diagnosis of intestinal obstruction due to the bezoar. A foreign body was found in the jejunum, and excised. The mass was black bezoar sized 4×3cm.<br> The bezoar is not dissolved by medication, and is often complicated with gastric ulcer and bowel obstruction. It is important to remove the bezoar as early as possible when it is discovered.

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