大腸Crohn病の1穿孔例 A FREE PERFORATION OF CROHN'S DISEASE OF THE COLON : REPORT OF A CASE

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大腸Crohn病の穿孔例を経験したので報告する.症例は23歳男性,全大腸型Crohn病の診断で他院にて加療されていたが,突然上腹部痛をきたし来院した.腹部単純X線写真,CTにて遊離ガス像を認めたため,消化管穿孔による腹膜炎と診断し緊急手術を施行した.上行結腸に穿孔が認められ,右半結腸切除を施行し,一期的に回腸横行結腸吻合を行った.病理組織学的には全層性の炎症細胞浸潤と非乾酪性肉芽腫を認めCrohn病と診断された.術後高熱やCRPの異常高値が持続したがステロイド剤の投与にて軽快し,その後特に合併症もなく経過,術後44日目に退院した.<br> Crohn病の大腸穿孔は比較的まれな合併症の一つであり,本邦では現在までに16例の報告をみるにすぎない.自験例を含む17例の本邦集計成績を中心に考察を加える.

This paper reports a case of Crohn's disease of the colon, complicated with free perforation with a review of the Japanese literature. A 23-year-old man has been followed with the diagnosis of Crohn's disease of the entire colon in another hospital. He was admitted to the hospital because of sudden onset of abdominal pain. Plain X-ray and CT scan disclosed a free air. Emergency operation was performed with a diagnosis of free perforation of G. I. tract. A free perforation was observed in the ascending colon. Right hemicolectomy with primary anastomosis was carried out. Pathological examination revealed transmural inflammation with noncaseous granulomas and the diagnosis of Crohn's disease of the colon was confirmed. During the early postoperative course, inflammatory reactions such as spike fever and elevated CRP, persisted for 4 days, which subsided with steroid administration. The patient was discharged one and half month after the surgery without any serious complication.<br> Free perforation of the colon is a rare complication in Crohn's disease and 16 cases have been reported so far in Japan.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 56(1), 126-130, 1995-01-25

    Japan Surgical Association

参考文献:  21件中 1-21件 を表示

被引用文献:  2件中 1-2件 を表示

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各種コード

  • NII論文ID(NAID)
    10008511274
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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