ID 110356
タイトルヨミ
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
タイトル別表記
A case of barium peritonitis causing postoperative empyema
著者
尾方, 信也 健康保険鳴門病院外科
田上, 誉史 健康保険鳴門病院外科
片川, 雅友 健康保険鳴門病院外科
坂東, 儀昭 健康保険鳴門病院外科
キーワード
barium peritonitis
pleural empyema
operation
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
67
1-2
開始ページ
65
終了ページ
70
並び順
65
発行日
2011-04-25
フルテキストファイル
言語
jpn
著者版フラグ
出版社版