小腸捻転をきたした小腸間膜リンパ管腫の1例

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  • A CASE OF A MESENTERIC LYMPHANGIOMA CAUSING VOLVULUS OF SMALL INTESTINE

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An 83-year-old woman complaining of vomiting was diagnosed as having ileus elsewhere and was referred to our hospital. Abdominal CT scan showed a hypo-vascular tumor about 10cm in longer diameter on the mesentery in the pelvic cavity and rotation of small intestine around the superior mesenteric artery near the ileocecal region. We diagnosed the case as a mesenteric tumor with volvulus of small intestine. At laparotomy, there was an irregular-shaped tumor on the mesentery which seemingly invaginated in the pelvic cavity. Fixation of the tumor in the pelvic cavity made the small intestine and mesentery twisted by about 360 degree counter-clockwise. As the twisted intestine was not ischemic or congestive, we resected the mesentery and the small intestine around the tumor. The resected tumor was diagnosed as cavernous lymphangioma of the mesentery by pathological examinations.<br> We consider this is a very rare case of mesenteric lymphangioma causing volvulus of small intestine.

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