蜂窩織炎性大腸炎の1例 [in Japanese] A CASE OF PHLEGMONOUS ENTEROCOLITIS [in Japanese]
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A 61-year-old man was seen at the department of internal medicine in our hospital because of massive hematemesis on August 8, 1999. With a diagnosis of rupture of an esophageal varix and liver cirrhosis, an endoscopic ligation of the varix was performed. While he was hospitalized thereafter, he had abdominal pain on August 27 which occurred in the morning and gradually progressed to shock state. An abdominal CT scan revealed prominent wall thickening of the intestine extending from the cecum to ascending colon, suggestive of high grade of intestinal edema. So the patient was referred to the department of surgery and underwent an emergency operation. At laparotomy, ischemic change on the ascending colon was confirmed, but no intraoperative definite diagnosis was made and a right colectomy was performed. Histopathologically remarkable submucosal diffuse infiltration of eosinophils was observed and phlegmonous enterocolitis was definitely diagnosed.The patient developed postoperative septicemic shock, liver and renal failure, and disseminated intravascular coagulation syndrome, and died on 16th day after the operation despite of intensive treatment. Although the diseases is a very rare entity, it often occurs in severe condition at the onset and resultantly has a poor prognosis. For early diagnosis, the disease must be kept acutely in mind for acute abdomen in patients with liver cirrhosis.
- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 62(4), 967-970, 2001-04-25
Japan Surgical Association