Abstract
A 73-year-old man, who had underwent poly-surgery because of perforation of a gastric ulcer and repeated adhesive ileus prior to his presentation, was admitted to our hospital after ingesting toilet acid detergent by mistake. Although he complained of strong upper abdominal pain with Blumberg sign, computed tomography revealed no evidence of the intestinal perforation. Conservative therapy including oral intake of milk was started. On day 15 of hospitalization, nausea developed. Duodenography performed on day 20 of hospitalization revealed intestinal stenosis from the 2nd portion of the duodenum to the jejunum proximal to the Treitz ligament. The stenosis was resolved temporarily by endoscopic therapy with a balloon dilator, but recurred immediately. A second attempt of endoscopic therapy caused perforation of the jejunum, so emergency laparotomy was performed. Simple closure of the perforation and gastro-jejunostomy for the stenosis was performed. But, 9 days after the operation, leakage from the anastomosis occurred and drainage was ineffective, so the operation was repeated. The leakage recurred presently, and long-term drainage was required. The leakage improved gradually and then disappeared. On day 90 of hospitalization, he was transported to the another hospital for rehabilitation.
