Lipohyperplasia が併存した回盲部単純性潰瘍の1例  [in Japanese] A Case of Simple Ulcer in the Ileocecal Region with Lipohyperplasia  [in Japanese]

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    • 太田 竜 OHTA Ryo
    • 川崎幸病院消化器病センター外科 Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital
    • 関川 浩司 SEKIKAWA Koji
    • 川崎幸病院消化器病センター外科 Department of Surgery, Institute of Gastroenterology, Kawasaki Saiwai Hospital


症例は31歳男性.腹部膨満感,嘔吐あり近医を受診し腸閉塞の診断で紹介となった.腹部CT検査で回盲部に5cm大の腫瘤があり,口側の小腸は拡張していた.注腸造影検査では上行結腸に隆起性病変があり,口側腸管は描出されなかった.大腸内視鏡検査では回盲部に炎症性ポリープが集簇しており回盲弁は不明であった.生検では炎症のみであり悪性所見はみられなかった.イレウス管を用いて減圧を行ったが腸閉塞は軽快せず大腸癌も否定できないため,腹腔鏡補助下回盲部切除術を施行した.回盲弁周囲に黄色調のmucosal bridgeを形成するpolypoid lesionが多発し腸管壁の肥厚を認めた.病理組織診では,Ul-IVの非特異性潰瘍とともに,被膜のない粘膜下層内の脂肪増生を生じていた.lipohyperplasiaが併存した回盲部単純性潰瘍というまれな症例を経験したので報告する.<br>

A 31-year-old man was admitted to our hospital under a diagnosis of ileus. Abdominal computed tomography scan revealed a tumor about 5cm in diameter at the cecum and diffuse dilatation of the small intestine. Barium enema study showed a mass at the ascending colon and the oral side of the mass was not detected. Colonoscopy showed many inflammatory polyps at the ileocecal region and the ileocecal valve was not detected. The biopsy specimen showed nonspecific inflammatory findings without malignancy. Because long tube decompression was not effective, laparoscopy-assisted removal of the ileocecal region was carried out. The resected specimen showed multiple polypoid lesions with mucosal bridge and wall thickness. Microscopical examination revealed non-specific ulcer of Ul-IV in depth and submucosal adipose tissues without capsule. We report a rare case of simple ulcer in the ileocecal region with lipohyperplasia.<br>


  • The Japanese journal of proctology  

    The Japanese journal of proctology 61(7), 415-419, 2008-07-01 

    The Japan Society of Coloproctology

References:  19

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