title: Rice cake ileus--a rare and ethnic but important disease status in east-southern Asia.
abstract: BACKGROUND
  Rice cake is a traditional but very popular food in Asia including Japan and has never been known as a cause of ileus. Rice cake is now becoming widespread in the United States and European countries along with other Japanese foods. We may encounter rice cake ileus all over the world. This study was aimed at characterizing the rice cake ileus.
  
  
  METHODS
  We consecutively encountered 14 patients with rice cake ileus from April 2003 to October 2010 in our hospital. All of the characteristics of the cases were reviewed and analyzed.
  
  
  RESULTS
  All patients had ingested rice cake by swallowing without chewing. It has most frequently occurred in January (57.1%). The main symptoms were abdominal colicky pain (100%) and nausea (85.7%) and physical findings included abdominal tenderness (100%) and muscular defense (28.6%). All patients improved by conservative therapy including fluid supply (100%), naso-gastric tube (28.6%) and long tube (28.6%) insertion. No patient needed emergency open surgery.
  
  
  CONCLUSIONS
  Rice cake ileus which is caused by swallowing the rice cake without chewing, frequently occurs in January, has previous history of abdominal surgery and shows high density intestinal contents on CT and only needs conservative therapy. Globalism in food culture may provide a new disease entity. Therefore, we should be aware of this type of ileus and be prepared to manage it appropriately.
authors.affiliation: Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Japan. tomiura@east.ncc.go.jp
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Miura
authors.forename: Naruhiro
authors.initials: N
authors.lastname: Kimura
authors.forename: Junichiro
authors.initials: J
authors.lastname: Nakamura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Miura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Yanagi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takaki
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Tani
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ito
authors.forename: Mamiko
authors.initials: M
authors.lastname: Nishihara
authors.forename: Toru
authors.initials: T
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005006:Ethnicity; D005260:Female; D006801:Humans; D045823:Ileus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D007564:Japan; D008297:Male; D008409:Mastication; D008875:Middle Aged; D012275:Oryza / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D012621:Seasons; D014057:Tomography, X-Ray Computed