胃切除後23年目に輸入脚症候群を呈した残胃癌の1例

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  • A CASE OF REMNANT GASTRIC CANCER WITH AFFERENT LOOP SYNDROME

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A case of cancer of the remnant stomach with afferent loop syndrome 23 years after gastric resection is reported, together with some bibliographical comments. A 75-year-old man was seen at the hospital because of abdominal pain and vomiting. There was a previous history of undergoing a Billroth II gastrectomy for gastric ulcer 23 years before admission. Dilation of the afferent loop was detected with computed tomography. Afferent loop syndrome was suspected and the patient was operated on. At laparotomy, the afferent loop was almost completely obstructed and extremely dilated due to a cancer of the remnant stomach. And the transverse colon also narrowed by the tumor invasion. Subtotal gastrectomy with resection of the transverse colon was performed. The tumor was 8.0×7.0×4.0cm in size and was histologically diagnosed as signet-ring cell carcinoma. After 9th postoperative day, the patient became to take foods by mouth, but he died 3 months after the operation.<br> Remnant gastric cancer with afferent loop syndrome is rare and only eight cases including ours have been reported in the Japanese literature. Almost all cases were in advanced stage with invasion into other organs and might have a poor prognosis.

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