Departmental Bulletin Paper 3次元Multi-detectorCT画像により早期診断し,大腸内視鏡下に摘出し得た爪楊枝による超高齢者大腸穿通の1例
Endoscopic removal of a toothpick penetrating the sigmoid colon diagnosed by multi-detector CT with 3D reconstruction

杉山, 浩平  ,  松山, 友美  ,  白井, 謙一  ,  簗瀬, 公嗣  ,  浪崎, 正  ,  山崎, 正晴  ,  吉治, 仁志  ,  福井, 博

66 ( 1-2 )  , pp.25 - 30 , 2015-04-30 , 奈良医学会 , 奈良県立医科大学
ISSN:13450069
NCID:AA11252383
Description
We present herein a case of sigmoid penetration, caused by accidental ingestion of a toothpick and resolved by endoscopic removal. An 85-year-old woman with moderate dementia was referred to our hospital by the primary care doctor for a further examination of minor localized left lower quadrant rebound tenderness. Multi-detector CT (MDCT) revealed sigmoid colon penetration by a linear structure and adjacent opaque adipose tissue. She was admitted as an emergency case to our hospital with localized peritonitis. A 3D reconstruction image confirmed that a 6 cm-long toothpick had pierced the sigmoid colon. However, the abdominal CT scan showed sigmoid colon penetration with no evidence of abscess formation or free air. Toothpick ingestion-related penetration was successfully managed with an endoscopic retrieval procedure followed by broad-spectrum antibiotic coverage. She was eventually discharged in fair condition. Here, we report this case of an 85-year-old female patient with accidentaltoothpick ingestion who was diagnosed with sigmoid colon penetration by MDCT with 3Dreconstruction, and underwent successful endoscopic removal.
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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3152/1/25-30p%ef%bc%9a3%e6%ac%a1%e5%85%83Multi-detectorCT%e7%94%bb%e5%83%8f%e3%81%ab%e3%82%88%e3%82%8a%e6%97%a9%e6%9c%9f%e8%a8%ba%e6%96%ad%e3%81%97%ef%bc%8c%e5%a4%a7%e8%85%b8%e5%86%85%e8%a6%96%e9%8f%a1%e4%b8%8b%e3%81%ab%e6%91%98%e5%87%ba%e3%81%97%e5%be%97%e3%81%9f%e7%88%aa%e6%a5%8a%e6%9e%9d%e3%81%ab%e3%82%88%e3%82%8b%e8%b6%85%e9%ab%98%e9%bd%a2%e8%80%85%e5%a4%a7%e8%85%b8%e7%a9%bf%e9%80%9a%e3%81%ae1%e4%be%8b.pdf

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