摂取された魚骨の穿通により生じた肛門周囲膿瘍の1例  [in Japanese] A Case of Perianal Abscess Caused by Penetration of an Ingested Fish Bone  [in Japanese]

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Author(s)

    • 佐田 明日香 SADA Asuka
    • 佐賀大学医学部内科学皮膚科 Division of Dermatology, Department of Internal Medicine, School of Medicine, Saga University
    • 三砂 範幸 MISAGO Noriyuki
    • 佐賀大学医学部内科学皮膚科 Division of Dermatology, Department of Internal Medicine, School of Medicine, Saga University
    • 成澤 寛 NARISAWA Yutaka
    • 佐賀大学医学部内科学皮膚科 Division of Dermatology, Department of Internal Medicine, School of Medicine, Saga University
    • 隅 健次 SUMI Kenji
    • 佐賀大学医学部一般・消化器外科 Department of General and Gastroenterological Surgery, School of Medicine, Saga University

Abstract

71歳,女性。1週間前より左臀部の紅斑・腫脹・疼痛が出現した。初診時,肛門左側から左臀部にかけて,びまん性の紅斑・腫脹・熱感を認めた。緊急手術を施行したところ,多量の排膿とともに鋭利な異物が発見された。異物は組織学的所見と形状から,魚骨と判断した。痔核や痔瘻は認められず,臀部慢性膿皮症などの所見もなく,膿瘍腔から魚骨が摘出されたことから,魚骨が肛門を穿通して皮下に迷入したことにより発症した肛門周囲膿瘍と診断した。魚骨の穿孔・穿通による肛門周囲膿瘍は,本邦において自験例を含め12例が報告されている。突然の肛門周囲膿瘍を見た場合には,稀ではあるが魚骨の穿孔や穿通による膿瘍形成も念頭におく必要があると考える。

A 71-year old woman presented with erythema, swelling and pain on the left buttock for one week. We recognized a diffusely erythematous, swollen and hot lesion from the left side of the perianal region to the left buttock. When we performed emergency surgery, a sharp foreign body was found with large amount of pus discharge. We judged the foreign body to be a fish bone based on the pathological finding and shape. Because of no findings of hemorrhoid or anal fistula and no finding of pyodermia chronica glutaealis, with a fish bone extirpated from the cavity of the abscess, we made a diagnosis of perianal abscess caused by a fish bone that had penetrated the anus and migrated to the subcutaneous tissue. There have been 12 reports of perianal abscess caused by perforation or penetration of fish bones in Japan, including our case. When examining an acute onset perianal abscess with no underlying disease, though it is rare, we suggest that perforation or penetration of a fish bone as a cause of the abscess should be considered.

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 71(4), 421-424, 2009

    Western Division of Japanese Dermatological Association

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