保存的治療が奏効した急性胆嚢炎による十二指腸狭窄の１例

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  • Conservative Therapy for Duodenal Stenosis due to Acute Cholecystitis with a Good Outcome. Report of a Case.

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We have experienced a case of duodenal stenosis probably due to acute cholecystitis which was successfully traeted by conservative therapy.<br> An 84-year-old man complaining of fever and mild upper abdominal pain was admitted to the hospital with a diagnosis of cold-induced gastroenteritis. Symptomatic remission had been achieving by infusion therapy with antibiotics, however, massive vomiting occurred on the seventh hospital day. Upper gastrointestinal series and an endoscopy revealed a stenosis at the descending part of the duodenum. Ultrasonographic study and a CT scan visualized the swollen gallbladder adjacent to the duodenal stenosis. Duodenal stenosis which might be caused by cholecystitis was diagnosed. The patient did not hope to undergo any operation for his advanced age. Conservative therapies including fasting, IVH, and administratiton of antibiotics were selected which yieled a release of the stenosis in about 10 days.<br> Although operation is employed in almost all patients with duodenal stenosis, there are some patients whose stenoses are successfully released by conservative therapy like this patient. We must carefully select candidates for operation from patients with duodenal stenosis.

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