ビワの種子により続発性に十二指腸狭窄を来した１例

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  • A Case of Duodenal Stenosis due to a Seed of Loquat

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A 80-year-old woman admitted for vomiting without bile juice after meals, anorexia, and upper abdominal distension. Plain abdominal computed tomography (CT) findings showed a high-density 1×1.5cm foreign body inside the second portion of the duodenum. Upper gastrointestinal endoscopy showed severe duodenal stenosis, necessitating laparotomy. After an unsuccessful attempt to reduce the mass, it was removed via duodenotomy on the opposite side of the ampulla of Vater. The mass was a loquat seed, probably ingested one month earlier. The seed was impacted in the duodenum, and adhered to the duodenal mucosa. No obstruction was seen on the anal end of the duodenum. The stenosis was close to the ampulla of Vater, eliminating the need for structure-plasty. After the duodenotomy was closed, we conducted gastrojejunostomy. The patient's postoperative course was uneventful. The fact that abdominal CT clearly showed the loquat seed contributed to greatly to diagnosis, together with the patient's detailed history.

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