Желудочно-кишечная и пищеварительная система

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An Improvement of an Ileus in the Jejunal Pouch by Aspiration with the Overtube of a Balloon Endoscopy: A Case Report

Takahiro Amano, Toshio Kuwai, Akiyoshi Tsuboi, Kazuki Boda, Ken Yamashita1, Yuichi Hiyama, Takeshi Mizumoto, Toshiki Yamaguchi, AtsushiYamaguchi, Hirotaka Kouno, Kiyomi Taniyama, Hiroshi Kohno

We report a case of an 86-year-old Japanese woman diagnosed with a food-induced ileus whose condition improved by aspiration with the overtube of a balloon endoscopy. She had undergone a total gastrectomy for gastric cancer and reconstruction by Roux-en Y anastomosis and jejunum pouch 17 years earlier. She complained of constipation and loss of appetite lasting more than 1 wk before admission. Her left abdomen showed gradual fullness, and tenderness was also found at the same site. Contrast computed tomography (CT) of the abdomen showed that the jejunal pouch lumenwas markedly expanded by food residue and was pressed into the intestinal tract of the small intestine. Gastrointestinal endoscopy revealed that the food residue was fluid and flowed back up into the esophagus, and the jejunum pouch was filled with food residue. As the patient was elderly, we attempted to aspirate the food residue with the overtube of a balloon endoscopy device. Food-induced ileus has been improved by surgery in the past; however, in determining treatment for ileus it is always necessary to consider the individual patients’ conditions, including the gastrointestinal contents.