酸化マグネシウム大量服用による直腸内腸石の1例 A Case of a Giant Enterolith in the Rectum Caused by Taking Large Doses of a Magnesium Oxide Laxative

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Abstract

酸化マグネシウムは副作用が比較的少なく安全な下剤であり,治療科目にとらわれず汎用される薬剤である.今回肛門狭窄を伴う便秘患者が酸化マグネシウムを大量服用することによって生じた直腸内巨大腸石症例を経験したので報告する.<BR>症例は69歳,女性.排便困難を主訴に来院した.肛門診察にて肛門狭窄を認めたため,10月8日入院し,肛門拡張術を施行した.退院後肛門指診にて,ざらざらした砂状の凝集塊と表面不整で非常に硬い腸石を認め,腹部X線を撮影したところ骨盤内に直径6cm大の腸石像を認めた.11月15日再入院し,直腸内腸石摘出術を行った.摘出標本は茶褐色で非常に硬く表面不整であった,腸石の成分は炭酸マグネシウムとして59.9%であり,酸化マグネシウムの大量常用による直腸内巨大腸石症と診断された.酸化マグネシウムは汎用される薬剤であるが安易に増量すべきでなく,他の薬剤を併用するなどの注意が必要と考えられた.

Magnesium oxide is said to be a safe laxative and is medicated commonly. We report here a case of a giant enterolith in the rectum, with anal stenosis, caused by taking large doses of magnesium oxide. A 69-year-old woman, complaining of difficulty in evacuation, was admitted to our hospital. Rectal examination revealed severe anal stenosis. Dilatation of the anal canal was performed under saddle block anesthesia. On digital examination at the first visit after discharge, we palpated a hard and rough mass in the rectum. Abdominal X-ray film revealed a giant enterolith in the rectum. The patient was readmitted, and extirpation of the stone was performed under anesthesia. The size of the mass was approximately 6cm in diameter, and the color was brown. It looked like a jagged rock. Chemical analysis showed 59.9%of the ingredient of the stone was magnesium carbonate. It was found that this case was a giant enterolith in the rectum caused by using large doses of magnesium oxide.

Journal

  • Nippon Daicho Komonbyo Gakkai Zasshi

    Nippon Daicho Komonbyo Gakkai Zasshi 55(6), 293-296, 2002-06-01

    The Japan Society of Coloproctology

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