術後20ヵ月に再発をきたした小腸間膜デスモイドの1例 A CASE OF A MESENTERIC DESMOID TUMOR THAT RECURRED 20 MONTHS AFTER SURGERY

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症例は56歳,男性.2004年9月,小腸GIST疑いで待機手術の予定であったが,白血球数,CRPの上昇,腹部の圧痛を認め,腫瘍穿孔による汎発性腹膜炎の診断で,緊急に腸間膜腫瘍切除,空腸部分切除,腹腔内洗浄,ドレナージ術を施行した.病理組織学的検査で腸間膜デスモイドと診断された.退院後,外来で経過観察としたが,2006年5月,術後20カ月に再発を認め,当科で再切除を行った.再切除後,小腸の広範囲切除により,短腸症候群となったが,内服薬でコントロールされ,63病日に退院した.外来,近医での点滴治療で経過観察としたが,既往のパーキンソン症候群の進行と短腸症候群による栄養状態の悪化により,再手術後5カ月で死亡した.

A 56-year-old male was scheduled to undergo elective surgery for a tumor of the small intestine in September 2004, but before surgery his white blood cell count and CRP level were elevated and he had abdominal tenderness. Thus emergency surgery was performed with a diagnosis of diffuse peritonitis caused by perforation of the tumor. The tumor was solid and 8 × 8 × 5 cm in size and was located in the mesentery proper. Resection of the mesenteric tumor, partial resection of the jejunum, intraperitoneal lavage, and drainage were performed. Mesenteric desmoid was diagnosed based on histopathological examinations. After discharge he had been observed as an outpatient until May 2006, 20 months after the surgery, when recurrence was discovered and re-resection was performed at our hospital. Massive resection of the small bowel over the two operations resulted in short-bowel syndrome, but it was controlled with oral medication and the patient's postoperative course was uneventful. He was discharged from the hospital 63 days after the second operation. During subsequent observation of the clinical course his underlying Parkinson's syndrome progressed, his general condition deteriorated due to short-bowel syndrome, and he died five months after the second operation.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association  

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 69(7), 1804-1808, 2008-07-25 

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10021945070
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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