合成吸収性癒着防止材を使用した胃全摘術後に発症した絞扼性イレウスの一例

The patient was a 50-year-old male. He underwent total gastrectomy with complication ablationof the greater omentum for gastric cancer. We used composition absorbent materials toprevent adhesion（seprafilm_）at closing of the abdominal wall. When he consulted our hospital forabdominal pain after 7 months later, we diagnosed the patient as having adhesive ileus. Severalhours later, he demonstrated abdominal swelling and fell into shock. Therefore, we performedurgent abdominal surgery. There were large quantities of cacosmia ascites and no adhesion exceptat only one point between the bottom of the previous wound and the small intestine. Weconfirmed strangulation ileus that had turned the small intestine with 360°dextroversion centeringon the adhesion point and the superior mesenteric artery root. Because most of small intestinehad become swollen and necrotized, we performed wide small intestinal resection with about 60cmsmall intestines survived. Currently we are following the patient with at-home intravenous hyperalimentationafter two further reoperations. At the time of the first operation, we had applied　seprafilm. This patient had a very late case of strangulation ileus, because there was almost noadhesion. This case represents a rare r side effect reports, involving shock, infection developingafter the use of seprafilm.