回腸狭窄をきたした回腸横行結腸側々吻合の1例  [in Japanese] A CASE OF ILEAL STRICTURES AFTER ILEOCOLIC SIDE-TO-SIDE ANASTOMOSIS  [in Japanese]

Access this Article

Search this Article

Author(s)

Abstract

症例は59歳男性.脱力感,腹痛のため当院に入院した.38年前に虫垂切除,腸閉塞手術の既往がある.貧血のため大腸内視鏡検査が行われ,横行結腸に多発潰瘍と長軸方向に並ぶ瘻孔を2カ所みとめた.注腸造影では横行結腸の内腔拡張と瘻孔開口部から拡張した回腸と収縮する回腸が造影された.回腸横行結腸吻合による盲係蹄症候群の診断にて開腹手術を行った.側々吻合部を切除し,短絡の解除を行った.回腸横行結腸吻合部の回腸近位側および遠位側は輪状狭窄し,組織学的に吻合部回腸には粘膜のびらんと急性腹膜炎をみとめた.小腸結腸短絡による盲係蹄症候群は短絡解除の手術適応となるため回腸狭窄など内視鏡診断が重要である.

A 59-year-old man was admitted to our hospital for a feeling of weakness and abdominal pain. He had a history of appendectomy and laparotomy for ileus 38 years ago. He was found to be anemic. Colonoscopy revealed multiple ulcerations with two fistulas, which ran in the longitudinal direction, in the transverse colon. Barium enema revealed dilation of the lumen of the transverse colon and fistulous openings from a dilated ileum and a contracted ileum. The patient was diagnosed with blind loop syndrome due to ileocolic side-to-side anastomosis, and laparotomy was performed. The ileocolic anastomosis was resected and the short circuit was released. Annular strictures of the proximal and the distal ileum were seen at the anastomotic site, and histological examination revealed erosion in the mucosa and acute peritonitis at the anastomotic site of the ileum. Endoscopic diagnosis, such as diagnosis of ileal strictures, was important because blind loop syndrome by short circuit of the small intestine and colon is an indication for surgical removal of the short circuit.

Journal

  • GASTROENTEROLOGICAL ENDOSCOPY

    GASTROENTEROLOGICAL ENDOSCOPY 58(5), 1044-1049, 2016

    Japan Gastroenterological Endoscopy Society

Codes

  • NII Article ID (NAID)
    130005152104
  • Text Lang
    JPN
  • ISSN
    0387-1207
  • Data Source
    J-STAGE 
Page Top