A Case of Food-induced Ileus Suspected as Being of Strangulated Ileus Based on Abdominal Findings at Presentation

Abstract

A 62-year-old man with severe abdominal pain consulted our hospital. His medical history included a gastrectomy 4 years earlier. Physical examination showed severe tenderness and abdominal distension. Muscle guarding and symptoms of abdominal irritation were observed on abdominal palpation. Laboratory findings showed leukocytosis, and a high level of CPK. A simple abdominal X-ray examination and CT scan both showed an expanded small intestine, filled with fluid and gas. The patient was diagnosed as having a strangulated ileus based on the abdominal findings, and underwent emergency surgery. Intraoperatively, a bolus of “itokonnyaku” was found to be causing an obstruction about 100 cm proximal to terminal ileum, and was removed to resolve the ileus. Among patients with food-induced intestinal obstruction who show severe abdominal findings, some cases may be difficult to differentiate from strangulated ileus. Preoperatively, it could be important to perform detailed questioning regarding the dietary habits of the patient.