空腸癒着性イレウスによる上腸間膜動脈症候群の1例 A CASE OF SUPERIOR MESENTERIC ARTERY SYNDROME CAUSED BY ADHESIVE ILEUS

この論文にアクセスする

この論文をさがす

著者

抄録

術後癒着性イレウスによる上腸間膜動脈症候群の1例を経験した.症例は84歳の男性で噴水状嘔吐と体重減少を主訴として来院した.慢性胆嚢炎に対し胆嚢摘出術を3カ月前に施行していた.上部消化管造影と腹部CTから上腸間膜動脈(SMA)による十二指腸第III部の閉塞と,空腸癒着性イレウスが疑われた.手術的治療として,癒着性イレウスの原因となった線維性索状物の除去とトライツ靱帯切除術を施行した.術後経過は良好であり,再発を認めなかった.上腸間膜動脈症候群は体重減少を伴う消耗性疾患に合併し上腸間膜動脈による十二指腸等III部の閉塞をきたす疾患である.自験例では,体重減少によるSMAと十二指腸第III部の解剖学的立位置関係の変化,トライツ靱帯より空腸にのびた癒着性索状物によるSMAを含む腸間膜根部の可動制限が本症の原因と思われた.

A case of superior mesenteric artery syndrome caused by mechanical ileus due to adhesive bands was reported. An 84-year-old male was admitted to the hospital because of explosive vomiting and body weight loss. There was a history of undergoing cholecystectomy for chronic cholecystitis had been carried out 3 months before. Gastrointestinography and computed tomography of the abdomen revealed that the 3rd portion of the duodenum was obstructed by superior mesenteric artery (SMA) and that the mechanical ileus was suspected at the jejunum. The adhesive band and Treiz's ligament were resected on laparotomy. Postoperative course was uneventful. There has been no evidence of recurrence of the symptoms after the surgery. SMA syndrome is well known as a disease which shows obstruction of the 3rd portion of the duodenum compressed by SMA and which is associated with such diseases that cause body weight loss. In this case, body weight loss and postoperative adhesion are concerned as etiological factors to complete duodenum obstruction. Because anatomical relationship between SMA and duodenum can be changeable by body weight loss, and because adhesive band of the jununum growed inferiorily from Treiz's ligament can reduce the flexible movement of the mesenterium involving SMA.

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(2), 375-378, 1995-02-25

    Japan Surgical Association

参考文献:  12件中 1-12件 を表示

被引用文献:  6件中 1-6件 を表示

各種コード

  • NII論文ID(NAID)
    10008511797
  • 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 
ページトップへ