A 42-year-old man with primary tongue cancer was admitted to our palliative care center for the control of pain due to multiple bone metastases. On 30th day after admission, he was suffering from pneumonia. And on 37th day, chest radiograph demonstrated pericardial emphysema, which developed to the pericardial abscess. Chest Computed Tomography showed lymph nodes metastases around the left main bronchus, and revealed that there was a fistula between the left main bronchus and the pericardium. The patient was faced to the difficulty in taking spine position because of excessive excretion of the sputum. Pericardiocentesis was then performed percutaneously and a tube for the drainage was placed. After the placement of drain tube, he restored good night sleep in the spine position and the complaints were reduced. Palliat Care Res 2008; 3(2): 321-325

PURPOSE: Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC. METHODS: The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters. RESULTS: The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14–72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850; 95% confidence interval, 1.009–8.044; P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO. CONCLUSION: The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.
Colitis, Ulcerative* ; Female ; Humans ; Ileostomy* ; Logistic Models ; Male ; Medical Records ; Risk Factors ; Tomography, X-Ray Computed ; Ulcer*