腸回転異常症を伴った原発性小腸癌の1例

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  • A Case of Small Intestinal Cancer with Intestinal Malrotation.

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A case of primary small intestinal cancer with intestinal malrotation is reported. A 58-year-old man was referred to the hospital because of abdominal fullness and vomiting. Upper gastrointestinal series presented an apple core sign at the small intestine. An endoscopic examination revealed a type 2 tumor in the small intestine and a biopsy sample offered a diagnosis of tubular adenocarcinoma. Serum CEA and CA 19-9 retained within normal levels. At laparotomy, nonrotation type malrotation and a tumor of the small intestine located about 20cm distal from the pylorus ring were recognized. A partial resection of the small intestine and dissection of regional lymph nodes were performed. Histological examination of the resected specimen revealed moderately differentiated adenocarcinoma with regional lymph node metastasis. We could obtain the precise preoperative histological diagnosis because the patient had malrotation. A long-standing constipation due to malrotation might contribute to the carcinogenesis in the present case.

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