卵管采部分絞拒扼死の1例 PARTIAL STRANGULATED NECROSIS OF THE TUBAL FIMBRIAE IN A 13-YEAR-OLD GIRL : A CASE REPORT

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右卵管采の部分絞扼壊死の稀な症例を経験したので報告する.症例は右下腹痛を主訴とする13歳,女児.持続する右下腹痛のため,虫垂炎疑で入院となった.発熱,白血球増多はなかった.右下腹の狭い領域に強い限局性圧痛がみられたが,腹痛が強い割に腹部所見が軽い事が特徴的だった.抗生物質の投与で経過観察下におかれたが,下腹痛は増強し,虫垂炎の診断で開腹手術した.虫垂は正常で,右卵管采のヒゲの1本が卵管と癒着してループを形成し,その輪の中に近傍の卵管采のヒゲ3本が入り込み絞扼壊死に陥っていた.壊死部を切除して手術を終了した.本疾患の病因である癒着の原因は不明だが,先天的な癒着によるものと推測された.術前診断は極めて困難であるが,女子の虫垂炎では本疾患を考慮にいれた附属器精査が必要と考える.

A very rare case of partial strangulated necrosis of the tubal fimbriae is reported. A 13-year-old girl was admitted to the hospital because of right lower abdominal pain. She was afebrile and white blood cell count was 6700. No abnormal findings were found by gynecological examination. Since intolerable right lower abdominal pain gradually increased, a laparotomy was performed. The appendix was normal and isolated strangulated necrosis of three fragments of the right tubal fimbria was observed. One fragment of the fimbriae was adhesive with a distal tube, formed a ring and near three fragments went into the ring, resulting in strangulation. To our knowledge, there has been no report with such a case. The cause of the adhesion was unknown. The preoperative diagnosis of this disease is very difficult, but it is important to examine the adnex at the question of a young girl with lower abdominal pain and without leucocvtosis.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 59(11), 2906-2908, 1998-11-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008437574
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  J-STAGE 
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