Two Cases of Intestinal Perforation After Examination of Intestinal Obstruction Using Gastrografin

Abstract

We report herein on two cases of small intestinal perforation after examination for an intestinal obstruction using Gastrografin. Case 1; A 56-year-old female was admitted under a diagnosis of intestinal obstruction after a total gastrectomy for gastric cancer. The intestinal obstruction was improved with conservative therapy. A follow-through examination with Gastrografin to evaluate the passage showed stenosis of the intestine. After 2 days, she had abdominal pain and abdominal distension. She underwent an emergency operation under the diagnosis of an intestinal perforation. The operative findings comprised a pin-hole perforation at the oral side of the stenosis. Case 2; In a 76-year-old male, intestinal obstruction was caused by adhesion after distal gastrectomy for gastric cancer. An intestinal tube was inserted for decompression of the intestine. After adequate decompression, Gastrografin was used to evaluate the passage. Next day, he went into shock with a diagnosis of intestinal perforation and underwent an emergency operation. An intestinal perforation similar to that in case 1 was found at the oral side of the stenosis. However, although both patients underwent successful emergency surgery, they died of sepsis. We report herein two important cases of intestinal perforation caused by Gastrografin.