魚骨の消化管穿通による腹腔内腫瘤の1例

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  • INTRAABDOMINAL TUMOR DUE TO INTESTINAL PERFORATION OF A FISH BONE

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A 48-year-old man visited another hospital because of an abdominal pain after meals lasting for one month and an abdominal tumor which was noticed recently. Abdominal CT revealed an intraabdominal tumor. The patient was admitted to the hospital for exploration. On admission an elastic hard tumor 8 cm in diameter with tenderness and smooth surface was plapated on the left side of the navel. On blood chemical analysis increases in leukocytes and CRP were noted. Abdominal CT and ultrasonography visualized a protruding tumor into the abdominal cavity which was internally heterogenous and associated with linear calcification in the lumen. Laparotomy was performed with a diagnosis of intraabdominal inflammatory tumor. The tumor strongly adhered to the transverse colon, was covered with the greater omentum, and was adjacent to the peritoneum beneath the left rectus abdominits muscle. The excised tumor was yellowish-white in color and solid involving pus partially and a foreign body which was probably a fish bone with a longer diameter of 4 cm was confirmed. In this case, it was thought that the fish bone perforated the transverse colon and formed an abscess in the abdominal cavity. When intraabdominal tumors of unknown origin are encountered, a possibility of perforation of some intestinal foreign body should be entertained in the diagnosis and treatment.

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