肛門より脱出したS状結腸粘膜下腫瘍の1例  [in Japanese] A CASE OF COLONIC SUBMUCOSAL TUMOR WITH PROLAPSE FROM THE ANUS  [in Japanese]

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Abstract

肛門からの腫瘤脱という稀な発症形式を呈した大腸脂肪腫の1例を経験した.症例は34歳,男性. 1997年排便時に肛門から拇指頭大の腫瘤が脱出した.その後腫瘤は次第に増大し, 2000年6月には手拳大となり還納が困難となった. 2000年7月16日排便時,腫瘤の脱出と共に下血が認められたため受診した.腫瘤はS状結腸に主座を置く直径約8×6cmの巨大な粘膜下腫瘍と診断され,これを先進部としての腸重積をきたし腫瘍が肛門から脱出したものと考えられた.同年8月25日手術施行,腫瘍径は3×2.5×2.5cmと縮小しており,病理学的に脂肪腫と診断された.脂肪腫では腫瘤径が4cmを超えると腸重積を合併する症例が多くなるとされる.また自壊により変形脱落することがあり,そのこと自体が脂肪腫の診断における重要な特徴であるともいわれる.本症例においても初診から手術までに約5週間が経過しており,この間に腫瘍の自壊脱落が生じたものと考えられた.

A case of colonic lipoma with prolapse from the anus is reported. A 34-year-old man was admitted to the hospital because of bloody stool and prolapse of a tumor from the anus on July 16, 2000. The manifestation of prolapse of the tumor had been experienced since 1997, and the size of the tumor gradually increased in the next 3 years. Barium enema and colonoscopy revealed a large submucosal tumor that was about 8×6cm in size and situated in the sigmoid colon. It was suspected that this tumor had caused intussusception and prolapsed from the anus. Partial resection of the sigmoid colon was performed on August 25, when the size of the tumor was decreased to 3×2.5×2.5cm. The pathological diagnosis was colonic lipoma. The reason of the reduction of this tumor is considered to be the disintegration and defluvium of lipoma that are the important features for diagnosis of colonic lipoma. In this case, the disintegration and defluvium might occur during about 5 weeks, from the first visit to the operation.

Journal

  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 63(4), 945-949, 2002-04-25

    Japan Surgical Association

References:  12

Cited by:  3

Codes

  • NII Article ID (NAID)
    10008619023
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    13452843
  • Data Source
    CJP  CJPref  J-STAGE 
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