Abstract
Rice cake is a traditional and popular food in Japan, and one of the foods which sometimes induce ileus.
In early January, a 60-year-old man who had been toothless and worn full dentures for 6 years and 10 months was admitted to the emergency department complaining of abdominal pain and vomiting which started when he got up. Computed tomography (CT) scan revealed a 30×22×6 mm cuboid-shaped high density structure in the terminal ileum and dilatation of the ileum proximal to the structure. It was inferred to be a rice cake which was swallowed down without chewing, when he did not wear his dentures, on the previous day. He was diagnosed with rice cake ileus. He had no fever and no peritoneal sign. There were no findings of intestinal ischemia except for mild intestinal dilatation. Thus we decided to treat conservatively with fasting, intravenous fluid supply and oral medication of 3g of comprehensive digestive enzymes (enzyme-rich pancreatin, biodiastase 1000, lipase AP6 and cellulase AP3) per day which break down proteins, carbohydrates and lipids. Two days later, he had defecation and abdominal pain disappeared. Abdominal CT scan showed high density materials in the colon, which might be pieces of the ingested rice cake.
Although food induced ileus is relatively rare, rice cake sometimes causes ileus in Japan. Conservative treatment with comprehensive digestive enzyme preparation was useful in the case of rice cake ileus.
