Mechanical ileus caused by a tablet of tralgit SR 100 stuck in a stenotic rectum affected by carcinoma: case report and literature survey.
A patient with an advanced carcinoma in the recto-sigmoideum was taken for urgent operation because of abdominal pain, significant distension of colon, clinical symptoms and radiological proofs of ileus. The cause of the complete obstruction of the proximal rectum which was significantly narrowed by a tumour was one tablet of Tralgit SR 100, which had been administered to the patient for 4 weeks after osteosynthesis of the right femur neck following fracture. According to the radiologist between 45 and 50 tablets of the medicament had been found in the digestive tract. The mechanical ileus was solved by operation according to Hartmann. This case has two aspects: 1) surgical--mechanical ileus resulting from a rare set of circumstances, and 2) pharmacological and metabolic--disorder of medicament absorption in the digestive tract. The cause of maldigestion (disorder of absorption) of the Tralgit tablets is further investigated.
(1) Surgical Department, Faculty Hospital and Academic Department of Surgery, Medical Faculty, Charles University, Hradec Králové, Czech Republic. kaskam@lfhk.cuni.cz
Milan
M
Kaska
Petr
P
Hoffmann
Martin
M
Oberreiter
D000701:Analgesics, Opioid / Q000009:adverse effects*; D005265:Femoral Neck Fractures / Q000601:surgery; D005593:Fracture Fixation, Internal; D006801:Humans; D045823:Ileus / Q000139:chemically induced* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D013607:Tablets; D014057:Tomography, X-Ray Computed; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects*
D000701:Analgesics, Opioid; D013607:Tablets; D014147:Tramadol