Abstract
We report a case of alimentary ileus-like condition due to ‘mochi’ persisted for 3 months with resultant perforation of the small intestine causing generalized peritonitis.
A 66-year-old man who had a previous history of undergoing a gastrectomy was admitted to the department of internal medicine in our hospital because of abdominal pain on December 18, 2001. Conservative therapy with a diagnosis of ileus was successful and the patient was discharged from the hospital. Thereafter he had occasional abdominal pain and was seen at the hospital because the abdominal pain became severe since the morning of March 29, 2002. Peritoneal signs were present in the abdomen. Abdominal CT scan visualized ileus image, intraabdominal free air, and a dense food mass with the longer diameter of 4 cm in the ileum. When we reviewed another abdominal CT scan performed in December, the similar food mass had been visualized. From these findings, a laparotomy was performed with a diagnosis of intestinal perforation with generalized peritonitis resulting from alimentary ileus-like condition persisted for 3 months. During surgery, we found a piece of ‘mochi’ impacted in the ileus and a perforated portion in the jejunum situating 180 cm oral side of the mass. The patient developed septicemia after the operation, but was successfully saved by intensive therapy.
This case is presented here because it is extremely rare that alimentary ileus-like condition persisted for 3 months resulted in small bowel perforation.
