Two Cases of Perforation of the Digestive Tract Caused by Press Through Package

Hiromasa Yamamoto¹⁾²⁾, Tetsunobu Udaka¹⁾, Masaki Tokumo¹⁾²⁾, Osanori Sogabe¹⁾, Minoru Mizuta¹⁾, Kazutoyo Shirakawa¹⁾ and Takashi Ohya¹⁾

¹⁾Department of Surgery, Mitoyo General Hospital
²⁾Department of Cancer and Thoracic Surgery, Graduate School of Medicine and Dentistry, Okayama University

We report 2 cases of perforation of the digestive tract caused by a mistakenly ingested press-through package (PTP). Case 1: A 97-year-old woman hospitalized for ileus was referred for surgery because conservative treatment did not relieve symptoms. Emergency surgery was conducted after abdominal CT indicated strangulated ileus. A PTP was found to have perforated the jejunum 130 cm from the Treitz ligament, due to penetration by a PTP. The jejunum, including the perforation, was partially resected. Case 2: A 65-year-old man treated as an outpatient for cerebral infarction and arteriosclerosis obliterans developed a sore throat and retrosternal pain after mistakenly ingesting a PTP. Emergency gastrointestinal fiberscopy on admission showed that the esophagus was perforated, necessitating emergency surgery. The perforation was directly sutured closed and gastrotomy conducted to remove the PTP. Reports of perforation of the digestive tract by PTPs are increasing, necessitating better guidance to patients in proper PTP use and improved PTP design.

Key words
press through package, perforation of the digestive tract

Reprint requests
Hiromasa Yamamoto Department of Cancer and Thoracic Surgery, Graduate School of Medicine and Dentistry, Okayama University
2-5-1 Shikata-cho, Okayama-city, 700-8558 JAPAN

Accepted
January 28, 2004

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