胃癌検診後に腸閉塞をきたしたバリウム糞石の1例

Ileus caused by a barium concrement impaction after upper gastrointestinal radiography for gastric cancer screening : a case report

◆要旨：患者は57歳，女性．胃癌検診での上部消化管造影検査後7日目に，排便困難と腹痛のため当院を紹介され受診した．精査でS状結腸内のバリウム糞石による腸閉塞と診断し，緊急手術を施行した．腹腔鏡下にS状結腸内のバリウム糞石の肛門側への移動は困難であった．下腹部に小開腹を行い，S状結腸を体外で切開し，最大径7cmのバリウム糞石を摘出した．術後の経過は良好で，14日目に退院した．バリウムによる稀な合併症に対し，腹腔鏡補助下手術が有用であった1例を報告する．

A 57-year-old woman presented with progressive constipation and abdominal pain, and then was referred to our hospital on day 7 after upper gastrointestinal radiography for gastric cancer screening. She was diagnosed with ileus caused by a barium concrement impaction and underwent emergency operation. Under laparoscopy, it was difficult to move the barium concrement in the sigmoid colon to the anal side with forceps, so a small laparotomy was made in the lower abdomen. The sigmoid colon was incised and the barium concrement 7cm in maximum diameter was extracted. The postoperative course was uneventful and the patient was discharged on the 14th postoperative day. We report a case of a rare complication related to barium radiography, for which laparoscopically assisted surgery was useful.