腹腔鏡補助下回腸部分切除術を施行した小腸Ｃｒｏｈｎ病の１例

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  • A case of Crohn's disease performed laparoscopy assisted partial resection of the ileum.

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A 29-year-old man was admitted to the department of internal medicine in our hospital with a diagnosis of intestinal obstruction in December 1998. Ileus tube fluoroscopy and a barium enema study revealed a narrowing at the end of ileum. Small bowel Crohn disease of the ileum end was diagnosed and nutritional therapy with elemental diet was started. The patient was discharged from the hospital after good clinical course. Thereafter, he was suffered from repeated intestinal obstruction due to associated low residue diet. Fluoroscopic examination of the small intestine revealed no improvement of the narrowing. The patient was considered a candidate for operation, and was operated on in February 2000. At laparotomy, the ileum 20cm from the ileocecum dilated like a loop due to adhesion, and a laparoscopy-assited partial resection of the ileum about 20cm in length was carried out. Resected material disclosed cobble stone appearance and longitudinal ulcer. Histopathologically, ulceration at the adhered intestine, fissure formation, infiltration of lymphocytes to the intestinal wall were observed. Consequently Crohn disease was definitely diagnosed. Postoperative course was uneventful. There have been no signs of recurrence of Crohn's disease up to now.

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