ID 110356
Title Transcription
ジュツゴ ノウキョウ オ ガッペイ シタ バリウム フクマクエン ノ イチレイ
Title Alternative
A case of barium peritonitis causing postoperative empyema
Author
Ogata, Shinya Department of Surgery, Health Insurance Naruto Hospital
Tagami, Yoshifumi Department of Surgery, Health Insurance Naruto Hospital
Katakawa, Masatomo Department of Surgery, Health Insurance Naruto Hospital
Bando, Yoshiaki Department of Surgery, Health Insurance Naruto Hospital
Keywords
barium peritonitis
pleural empyema
operation
Content Type
Journal Article
Description
The patient was a 40-year-old woman. She visited our hospital because of sudden pain developing 4 days after upper gastrointestinal radiography with barium. Her abdomen showed board like rigidity. On the basis of abdominal radiography and computed tomography(CT)findings, we made a diagnosis of barium peritonitis. Emergency surgery was performed on the same day. A 3-cm diameter perforation was noted in the sigmoid colon. The perforated area had been plugged with fecal mass of a size larger than the fist. Purulent ascites, mixed with food residues, were noted in the peritoneal cavity, and the leaked barium had attached to the mesentery and intestine. Cleansing with about10,000mL warm physiological saline was carried out to remove these contaminants. Because postoperative inflammatory reactions persisted, thoracic and abdominal CT scans were obtained on the10th hospital day ; they showed bilateral hydrothorax as well as residual barium and abscess under the left diaphragm. The patient was treated conservatively, but thoracic and abdominal CT scans obtained on the 44th hospital day allowed a diagnosis of left empyema. On the same day, lavage and drainage of the empyema-affected area were carried out. This resulted in the alleviation of the postoperative inflammatory reactions. The residual barium under the left diaphragm was considered as the cause of the postoperative condition in this case. Upon detection of barium peritonitis, it is essential to diagnose the underling condition as soon as possible and to completely(leaving no residual barium)and immediately remove the barium.
Journal Title
四国医学雑誌
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
67
Issue
1-2
Start Page
65
End Page
70
Sort Key
65
Published Date
2011-04-25
FullText File
language
jpn
TextVersion
Publisher