A Case Treated with Oren-Gedoku-to for Mucous Staining in the Underwear after Low Anterior Rectal Resection.
10.3937/kampomed.45.371
- VernacularTitle:直腸低位前方切除術後，粘液による下着汚染に対する黄連解毒湯の一使用経験例
- Author:
Seiji KOYAMA
- Publication Type:Journal Article
- Keywords:
after low anterior rectal resection;
mucous staining in the underwear;
Oren-gedoku-to;
anal sphincter hypotonia;
Hochu-ekki-to
- From:Kampo Medicine
1994;45(2):371-376
- CountryJapan
- Language:Japanese
-
Abstract:
Low anterior rectal resection was performed for lower rectal sm carcinoma. The patient had not complained of staining his underwear while hospitalized but only when he resumed work as a metal sheet worker. He then started to find his underwear stained with mucus.
The operation he had undergone was end to end anastomosis of the sigmoid colon and the rectum with EEA mechanical anastomosis. During the operation, there was an insecure site in one part of the doughnut ring, and therefore another three stitches for total layered suturing were made manually. An artificial anus was introduced temporarily. Since IVH was performed for two weeks after operation, no particular sutural insufficiency was noted.
It was assumed that underwear staining with mucus was due to some kind of persistent inflammation at the site of anastomosis. Based on Kampo medicine, the patient was diagnosed as “pathogenic dampness-heat combination”, and was given Oren-gedoku-to to clear away “heat-evil and dampness-evil”. This Kampo preparation proved to be very effective. The underwear staining was reduced considerably, though the anal sphincter remained hypotonic. Hochu-ekki-to was given to elevate and resume sphincteral tension. No report has previously been made concerning the use of a Kampo formulation in mucous staining of the underwear after low anterior rectal resection.
