腹壁膿瘍にて発見された胃結腸瘻を伴う横行結腸癌の1例 A CASE OF GASTROCOLIC FISTULA DUE TO CANCER OF THE TRANSVERSE COLON DISCOVERED WITH AN ABSCESS OF THE ABDOMINAL WALL

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症例は56歳,女性.左上腹部の有痛性腫瘤の増大と発熱を主訴に当科入院した.高度の貧血と炎症反応がみられ,腹部超音波・CT検査にて腹壁膿瘍が認められた.膿瘍よりE. coliが検出され,膿瘍造影では横行結腸の描出とそれに引き続き胃が造影された.内外瘻形成を有する横行結腸癌の診断にて開腹,横行結腸切除+胃亜全摘,腹壁合併切除を施行した.病理組織所見では高分化型腺癌, n(-)であり,経過良好にて術後27日目に退院した.<br> 結腸癌による胃結腸瘻形成には自験例を含め本邦では27例報告されているにすぎず,本症例のごとく腹壁膿瘍,胃結腸瘻を合併した横行結腸癌は極めて稀である.しかし積極的な合併切除により予後は十分期待できるものと思われた.

A 56-year-old woman admitted to the hospital because of an enlarging left hypochondral painful mass and fever. There was high grade anemia and inflammatory reaction in her laboratory data. Absces formation in the abdominal wall was revealed by ultrasonography and CT scan. E. coli was detected by the culture from the abscess and X-ray with Urograffin showed the fistula between the abscess cavity and transverse colon accompanied with stomach. The patient was diagnosed as malignant gastrocolic fistula due to cancer of the transverse colon. Curative operation (transverse colectomy, gastrectomy and partial resection of the abdominal wall) was performed. Histopathologically it was well-differentiated adenocarcinoma without lympn node metastasis. The patient was discharged from the hospital 27 days after the operation with an uneventful clinical course. Only 27 cases of gastrocolic fistula due to colonic cancer have been reported in Japan, and colonic cancer with abdominal abscess and gastrocolic fistula is especially rare. Aggressive resection of the invaded organ appears to promise a favorable prognosis for malignant gastrocolic fistura.

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), 384-389, 1995-02-25

    Japan Surgical Association

参考文献:  31件中 1-31件 を表示

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各種コード

  • NII論文ID(NAID)
    10008511823
  • 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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