新生児期に発症した回腸部分拡張症の2例  [in Japanese] Two Cases of Segmental Dilatation of Ileum  [in Japanese]

腸管部分拡張症(消化管部分拡張症)は比較的まれな疾患である.今回われわれは,新生児期に発症した,回腸部分拡張症を経験した.症例1は日齢21の男児.主訴は腹部膨満.日齢21に経鼻胃管から顆粒便様の吐物の吸引を認め,腸回転異常症を疑い開腹術を施行した.症例2は生後24時間胎便排泄がなく,浣腸で排便認めるも,次第に腹部膨満が認められ,Hirschsprung病あるいは腸管部分拡張症を疑い,日齢3に試験開腹となった.両症例とも回腸に拡張腸管を認め,腸管部分拡張症の診断で,拡張腸管を切除し端々吻合した.病理所見は,神経節細胞に形態・分布異常は認めなかった.術後経過は良好である.腸管部分拡張症について,若干の文献的考察を加えて報告する.

Segmental dilatation of the intestine is a relatively rare pathological condition. We report two cases of segmental intestinal dilatation of the ileum in newborns. Case 1 was a 21-day-old boy whose chief complaint was abdominal distention. Intestinal malrotation was suspected after inhalation of grainy vomit occurred at 21 days old, and laparotomy was performed. Case 2 was a boy who failed to pass meconium within 24 hours of birth. An enema was administered and stools were passed but abdominal distention increased progressively. Hirschsprung's disease or intestinal malrotation were suspected and exploratory laparotomy was performed on the third day of his life. Segmental dilatation of the ileum, which was observed in both cases, confirmed the diagnosis of segmental dilatation of the intestine. Both cases were treated by resection of the dilated segment and an end-to-end anastomosis. Pathological findings did not reveal any morphological or distributional abnormalities of the ganglion cells. The postoperative course was uneventful in both cases. This report provides case reports of segmental dilatation of the intestine with a brief review of the literature.