Two Cases of Food-induced Ileus due to Shiitake Mushroom Respectively Treated with an Operation and Conservative Treatment

Abstract

【Case 1】 A 77-year-old woman with dementia was admitted to our hospital complaining of abdominal pain and vomiting. We performed an operation because we suspected intussusception or foreign body impaction of the small intestine based on a computed tomography (CT) scan. A shiitake mushroom, 7cm in diameter and retaining its original form, was found in the ileum about 150cm proximal from the cecum. 【Case 2】 A 59-year-old man was admitted to our hospital complaining of abdominal pain. We diagnosed food-induced ileus due to a shiitake mushroom based on his dietary history and CT scan. Because there were no findings suggesting ischemia and necrosis of the small intestine, a long tube was inserted for conservative treatment, and after that, his symptoms improved. There were eighteen previous cases in which Shiitake mushrooms caused food-induced ileus in Japan. Referring to the past and present cases, CT images and the dietary history of the patients are important for diagnosis, and it is necessary to consider the size of the mushrooms and laparotomy history of the patients in the treatment strategy.