腸間膜脂肪織炎が最も考えられたS状結腸狭窄の1例

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  • A CASE OF SIGMOID COLON STRICTURE THAT WAS MOSTLY CONSIDERED MESENTERIC PANNICULITIS

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An 81-year old man was seen at the hospital because of constipation, left low abdominal pain and a left low abdominal mass, and was admitted for ileus. Mesenteric panniculitis was diagnosed as a result of barium enema that showed a narrow space of the colon like a sow shape existing from the rectum to sigmoid colon, and of CT findings that showed an increace in low-density volume including high density funicular image of fat tissue surrounding the mesentery of the sigmoid colon. Although he was healed by fast, IVH and antibiotics and was discharged, he complained of the same symptoms again 2 weeks later. Lapalotomy was performed because we decided that the surgical treatment was needed for this patient. During surgery we could clearly see the findings of panniculitis of the sigmoid colon and there was no sign of cancer, and so a loop-colostomy at transverse colon was made excepting biopsy and colon resection. The above symptoms rapidly disappeared after the operation and there have been no signs of recurrence up to now. A barium enema study 1 year after the operation showed disappearance of the sow shape, a wide of the caliber and a restoration of flexibility of the sigmoid colon. If there would be necessary to add surgical treatment for the mesenteric panniculitis of the sigmoid colon, the lesion would be improved by only the isolation of the focus with making colostomy.

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