2020 Volume 45 Issue 4 Pages 356-362
An 80-year-old woman was admitted to our hospital complaining of abdominal pain. She was diagnosed as having enteritis, prescribed medications, and discharged home. Subsequently, she returned to our hospital again complaining of vomiting and bloating. Abdominal computed tomography performed a second time at admission showed ascites on the liver surface and intestinal edema, which had not been observed in the first CT performed at the previous admission. The patient had a history of having undergone surgery for appendicitis, so suspecting the possibility of strangulated bowel obstruction caused by adhesions, we performed emergency laparotomy. A hard substance was detected in the intestinal tract about 10 cm proximal to the terminal ileum, and we diagnosed the patient as having food-induced bowel obstruction. The hard substance could not be negotiated through the Bauhin valve, so that we had to cut the intestinal tract open to remove it appeared to be a fibrous bolus. Food residue in the oral intestinal tract was drained as much as possible, and the incision was closed with sutures. A postoperative questionnaire confirmed that the patient had eaten dried apples. Cases of food-induced bowel obstruction caused by dried fruits are extremely rare, with only three previous reports, in addition to our own case. Dried fruits should be considered as a possible cause in the differential diagnosis of food-induced bowel obstruction.
