スッポン骨による小腸穿孔の1例

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  • A CASE OF PERFORATION OF THE SMALL INTESTINE BY A SOFT SHELLED TURTLE'S BONE

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A 41-year-old man visited another hospital because of migratory abdominal pain after having scalloped sofe shelled turtle. The patient was transported to our hospital with a diagnosis of panperitonitis. Although plain chest and abdominal pain X-ray films showed no significant sign, abdominal CT revealed panperitonitis due to perforation of the small intestine by a foreign. Emergency laparotomy was performed and the perforation in the ileum located 160cm oral from the teminal ileum was confirmed. The foreign body was recognized in the terminal ileum and was removed with ileostomy. It was a bone of soft shelled turtle 35mm in length.<br> The patient was eventually recovered and discharged from the hospital onthe 20th postoperative day. This case is presented with discussion of the relevent literature including 195 cases of gastrointestinal perforation or penetration by a foreign body reported during the past seven years. gastrointestinal perforation by a foreign body should be considered as a probable differential diagnosis for panperitonitis, unaccountable intraabdominal abscess or tumor.<br> Detail collection of patient's history and CT scan are especially beneficial to make the precise diagnosis of perforation by a foreign body.

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