穿孔をきたしたと考えられる回腸カルチノイドの１例

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  • A Case of Carcinoid of the Ileum with Suggestion of Perforation of the Tumor.

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Perforation of carcinoid of the small intestine is rare. In this paper, we report a case of carcinoid of the ileum, which had a clinical episode of panperitonitis due to perforation of the tumor.<br>A 70-year-old man was admitted to the hospital because of incarceration of right inguinal hernia and ileus. There was a previous history of receiving conservative therapy for symptoms of peritonitis at another hospital one month before admission. Immediately after admission, a reduction of incarcerated hernia was done manually and a radical herniorraphy was performed on the fifth hospital day. Adhesion between the hernia sack and small intestine was recognized. At the seventh day after the operation, recidivation of the ileus occurred. He was diagnosed as having ischemic ileitis of stenotic type caused by incarcerated hernia on a contrast ileography, and underwent another operation on 17th day after the first operation. Diffuse adhesion of the intestine due to previous peritonitis existed. Stenosis of the ileum at about 3m anal side from the Treiz ligament was recognized. We considered it as cicatrical contraction after perforation, and performed a partial ileectomy. The resected specimen showed no obvious tumor but a histological examination revealed an island proliferation of small, homogenous tumor cells which were positive on immunohistochemical stainings such as Gromerius, Fontana-Mason and chromogranin stain. The difinite diagnosis of argentaffinity, insular type carcinoid of the ileum was made.

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