魚骨による虫垂穿孔の1例

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  • A CASE OF PERFORATION OF THE APPENDIX BY A FISH BONE

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A case of perforation of the appendix due to a fish bone with a course of long duration is reported.<br> A 51-year-old man complaining of right lower abdominal pain and hematuria underwent close examination at another hospital, but no urinary abnormalities were revealed and the patient had been conservatively treated. Thereafter, he was referred to the department of urology in our hospital because of recurrent symp-toms, when inflammatory findings and abdominal pain became worse. So he was admitted to the department with a diagnosis of peritonitis after unsuccessful conservative treatment for 3 months. Although no abnormal findings were seen in the conventional radiographic study, a CT scan preliminary offered a screpicion of the existence of a foreign body at the ileocolic region. The shape of fish bone penetrated from the appendix was clearly captured by a ultrasonographic study. With a diagnosis of localized peritonitis due to a fish bone, the patient was operated on. During surgery, the appendix together with the terminal ileum strongly adhered to the cystic wall. The resected material indicated that the fish bone penetrated from around the root of appendix to serosa. Postoperative course was uneventful and the patient was dischaged from the hospital on 20th postoperative day. It should be emphasized that CT scan, ultrasonography, and carefully taken histories are important for the diagnosis of intestinal penetration by foreign bodies.

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