Departmental Bulletin Paper 胃癌再発の悪性小腸狭窄に対するステント留置後の穿孔性腹膜炎の1例
A Case of Perforated Peritonitis After Stent Placement for Malignant lntestinal Obstruction due to Peritoneal Metastasis from Gastric Cancer

天木, 美里  ,  矢島, 和人  ,  岩崎, 善毅  ,  大日向, 玲紀  ,  Amaki, Misato  ,  Yajima, Kazuhito  ,  Iwasak, Yoshiaki  ,  Oohinata, Ryouki

131 ( 2 )  , pp.115 - 120 , 2017-02 , 新潟医学会
An 85-year-old man, who had a history of distal gastrectomy with reconstruction by the Roux-en-Y method for advanced gastric cancer, suffered from dysphagia 62 months after the initial gastrectomy. A diagnosis of malignant intestinal obstruction of reconstructed jejunum from the gastric cancer was made by endoscopic biopsy. Insertion of a metallic stent was selected for palliation because of his age and general condition. His oral intake became good after stenting, and paclitaxel was administered for the recurrence of gastric cancer, He was admitted with severe abdominal pain 35 days after the stenting. Abdominal CT scan revealed intra- abdominal free air around the inserted stent ; this finding was compatible with perforated peritonitis after the stent placement. A pin- holed perforation was identified at the site of stenting at laparotomy, and surgery including irrigation and drainage were performed urgently. He could consume sufficient food, but died 181 days after the stent insertion without hospitalization. In this case, stent insertion was seen both to benefit long - term oral intake and to have the drawback of intestinal perforation.

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