A CASE OF FOOD-INDUCED ILEUS DUE TO A SEED OF PEACH

Abstract

A 66-year-old man who had been hospitalized for schizophrenia at a mental hospital was admitted to the hospital because of a sudden onset of abdominal pain and distension. There was a previous history of undergoing an appendectomy at the age of 38. A simple X-ray film of the abdomen showed a mass shadow with dilatation of the small intestine and niveau. Abdominal CT scan revealed a shadow of a foreign body like a seed of plant in the terminal ileum with a significant dilatation of the proximal small intestine. The patient was diagnosed as having intestinal obstruction due to some seed of plant. Conservative treatment by an ileus tube was ineffective, therefore an emergency operation was done. At laparotomy, there was adhesion of the ileum owing to the previous appendectomy. A foreign body was impacted in the ileum 30cm distal from the Bauhin's valve. The ileum wall was to be fragile after adhesiotomy, and so a partial resection of the ileum including the foreign body was performed. The foreign body was a seed of peach, measured 4.5×3.5cm in size. In this case, we could not know the kind of foreign body because of difficulty in taking history due to his mental disease, but an abdominal CT scan showed the characteristic image of the seed. This imaging procedure contributes to make the diagnosis of the disease.