上行結腸腹膜垂捻転症の1例  [in Japanese] TORSION OF THE APPENDICE EPIPLOICAE : A CASE REPORT  [in Japanese]

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Abstract

今回われわれは急性虫垂炎と考え手術を施行し,術中所見および組織診断にて上行結腸腹膜垂捻転症と考えられた症例を経験したので報告する.症例は30歳,男性.右下腹部痛を主訴に来院した.理学所見および炎症所見から考えて,急性虫垂炎の診断で手術を施行した.開腹すると,虫垂自体は正常であったが,上行結腸に暗赤色で大きさ径25×10mmの腹膜垂を認めた.この腹膜垂が根部で捻転しており,これが疼痛の原因と考えられた.この腹膜垂を切除し手術を終了した.腹膜垂は直腸下部を除き全結腸に存在している.これが急激な体動などにより根部から捻転すると梗塞を起こす.これにより,腹痛を生じ,時には急性腹症で来院することもある.また,切離して腹腔内遊離体となることやその他の部位に癒着して腸閉塞の原因となるという報告もある.そのため,疾患としてはそれほど重篤ではないが,鑑別疾患の一つとして念頭に入れておくべき疾患と考えられる.

We encountered a case of torsion of the appendice epiploicae, which was suspected of acute appendicitis preoperatively. A 30-year-old male was seen at the hospital for a right lower abdominal pain. a preoperative diagnosis of acute appendicitis was made and an emergency surgery was performed. At surgery, the appendix was normal but reddish appendice epiploicae 15 mm in diameter arising from the ascending colon was found, twisted tightly at the pedicle. The epiploicae and appendix were removed. The appendices epiploicae are peritoneal-encases, fat-filled, pedunculated structures along the entire length of the large bowel, with the exception of the lower rectum. Torsion of the appendice epiploicae may produce symptoms of peritoneal irritation severe enough to require surgery. On rare occasions, due to marked torsion of the pedicle, the peritoneal covering of the may become tightly drawn forming a web, any may present features of intestinal obstruction. Infarction of the appendices epiploicae may produce hemorrhage and inflammation with subsequent peritonitis, causing an acute abdomen. Therefore, every surgeon should be aware of this condition because lack of familiarity with its surgical pathology can lead to make an erroneous diagnose.

Journal

  • The journal of the Japanese Practical Surgeon Society

    The journal of the Japanese Practical Surgeon Society 57(8), 1979-1982, 1996-08-25

    Japan Surgical Association

References:  14

Cited by:  1

Codes

  • NII Article ID (NAID)
    10008523571
  • NII NACSIS-CAT ID (NCID)
    AN00198696
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03869776
  • Data Source
    CJP  CJPref  J-STAGE 
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