下行結腸腹膜垂炎の１例

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  • A Case of Epiploic Appendagitis of the Descending Colon.

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A 52-year-old man was admitted to our hospital with progressive and constant pain in the left lower abdomen. An elastic, tender, egg-sized mass was present in the left lower abdomen. Barium enema radiography revealed an extrinsic compression and a mucosal crenulation in the distal side of the descending colon. Colonoscopic examination showed a submucosal tumor-like protruded lesion covered with normal mucosa in the descending colon, and neither erosion nor ulceration was seen.<BR>Computed tomography revealed wall thickening of the descending colon, with an increase of the surrounding fat tissue density. Although localized inflammation of adipose tissue was suspected, no definite diagnosis was possible.<BR>At laparotomy, an enlarged, dark-red epiploic appendage was found on the distal side of the descending colon, and resection of the inflamed epiploic appendage was performed.<BR>Pathological examination showed congestion, necrosis, and infiltration of inflammatory cells and foamy cells.<BR>The diagnosis of epiploic appendagitis was established. It is extremely difficult to make a definite diagnosis of epiploic appendagitis prior to surgery ; none of the case reports were diagnosed preoperatively. The present case is thought to be a rare case in which the morphologic characteristics of epiploic appendagitis were displayed.

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