急性胆嚢炎を合併した胆嚢癌症例の検討 INVESTIGATION OF THE GALLBLADDER CARCINOMA ACCOMPANIED WITH ACUTE CHOLECYSTITIS

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われわれは急性胆嚢炎を合併した胆嚢癌症例を5例経験しているが,それぞれに病態,原因が異なっていた.そこで自験例を呈示し,その原因,診断を中心に検討を行った.<br> 1例は癌と胆嚢炎に関連はなく,結石嵌頓による急性胆嚢炎に偶然癌が合併していた.他の4例は癌が胆嚢炎を誘発しており, 1例は胆嚢体部の癌が広範に浸潤したために頚部に浮腫を伴って結石が嵌頓し,急性胆嚢炎を起こしたもの, 1例は胆嚢管原発の胆嚢癌で胆嚢管閉塞による急性胆嚢炎を起こしたもの, 2例は胆嚢癌による腫瘍壊死組織が胆嚢内腔に充満したために急性胆嚢炎を起こしたものであった.<br> このように病態,原因はそれぞれに異なっており,さらに炎症で画像が修飾されて術前診断は困難な場合もあった.したがって,画像診断で急性胆嚢炎と思われても,常に癌の合併に注意を払った観察,検査が必要であると考えられた.

An investigation was made on the causes and diagnosis in 5 cases of gallbladder carcinoma ac-companied with acute cholecystitis which had different pathosis and causes each other.<br> One case was of acute cholecystitis caused by calculus impaction accompanied with abiogenetic carcinoma without any relationship between the carcinoma and cholecystitis. Of the remaining 4 cases of cholecystitis caused by a gallbladder carcinoma, one case developed acute cholecystitis with an impacted calculus which was accompanied with edema in the neck due to wide-spreading invasion of carcinoma in the main gallbladder; another one case developed acute cholecystitis with occlusion of the cystic duct due to a gallbladder carcinoma arising in the duct; and two cases developed acute cholecystitis, because tumor necrosis tissue due to a gallbladder carcinoma fully occupied the lumen of the gallbladder.<br> The pathosis and causes of cholecystitis were different from each other as mentioned above, and unclear images due to inflammation sometimes disturbed us in making the preoperative diagnosis. Accordingly, it is necessary to carry out careful observation and inspection always with attention to possible complication of carcinoma, even if the image diagnoses exhibit acute cholecystitis.

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(8), 1662-1666, 1995-08-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008515090
  • 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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