Small bowel obstruction by food impaction is relatively rarely encountered. In general, the impacted foods are fruits, konbu, Konnyaku, and tsukemono. A properative diagnosis is quite difficult to be established, because the symptoms are similar to the bowel obstruction by any other causes. On the other hand, the bowel obstruction by foodstuffs can be frequently seen postgastrectomy patients.
A 54-year-old woman, having a previous history of undergoing subtotal gastrectomy for gastric ulcer with reconstruction by means of Billroth II method 22 years before, developed bowel obstruction due to “konnyaku”. On the morning following her taking “konnyaku”at dinner, she was seen at the hospital because of severe upper abdominal pain as well as nausea and vomiting. Abdominal X-ray film revealed small bowel gas accompanied by fluid level. A diagnosis of adhesive bowel obstruction was made. Laparotomy was performed and an impacted foodstuff was seen in the small bowel about 210cm from the end of ileum. After moving the impacted foodstuff from the jejunum to the ileum, it was removed from the ileum by ileotomy. It was found to be a mass of “konnyaku” taken at dinner. This case suggested that asking of the meals taken before played a great role in making the diagnosis of foodstuff bowel obstruction, especially for patients after gastrectomy.