多発性腸管穿孔をきたした胃癌術後のサイトメガロウイルス腸炎の１例

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  • A Case Report of Multiple Intestinal Perforations by Cytomegalovirus Enterocolitis after a Total Gastrectomy.

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Cytomegalovirus (CMV) enterocolitis is known as a complication of immunocompromised patients and its manifestation in immunocompetent patients is rare. This article presents a patient who developed multiple intestinal perforations by CMV enterocolitis. A 50-year-old man underwent a total gastrectomy for gastric cancer. Four weeks after the operation, multiple colonic perforations developed requiring an emergency total colectomy. Furthermore, ileal perforation occurred 10 days after the total colectomy. Immunohistochemical study of the resected specimen revealed CMV positive cell infiltration into the colonic mucosa. A diagnosis of CMV enterocolitis was made and ganciclovir was administered. After ganciclovir treatment, inflammatory change of the intestine diminished and the patient was discharged in a good condition. Most of the reported cases of CMV enterocolitis in Japan were associated with immunocompromised condition. However, CMV enterocolitis may develop in an otherwise normal patients and this is the first case of the disease appeared with multiple intestinal perforations during postoperative period.

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