S状結腸に穿通した卵巣成熟嚢胞性奇形腫の1例  [in Japanese] A Case of an Ovarian Mature Cystic Teratoma Penetrated into the Sigmoid Colon  [in Japanese]

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Abstract

症例は85歳,女性.前日からの発熱が持続し当院を受診した.来院時は39.5度の発熱,下腹部の膨隆を認め,圧痛を伴う腫瘤を触知した.腹部CT検査では,骨盤腔内にガス,液体貯留,5cm大の棒状高吸収像を伴う嚢胞状腫瘤を認め,卵巣奇形腫によるS状結腸穿通が疑われた.全身状態を考慮し,緊急で局所麻酔での嚢胞内ドレナージ術を施行した.術中所見では嚢胞内容物は便汁だった.後日,全身麻酔での開腹手術を施行した.術中所見では,左卵巣の嚢胞性腫瘍とS状結腸が穿通し強固に癒着していた.左卵巣腫瘍摘出,S状結腸切除,人工肛門造設術を行った.病理組織学的には卵巣成熟嚢胞性奇形腫の診断で,悪性所見は認めなかった.卵巣腫瘍の消化管穿通は稀であるが,重篤な全身状態に進展する可能性があり,早急な診断と治療を行う必要があると考えられた.

An 85-year-old woman was admitted to our hospital because of fever lasting from the previous day. When she was first seen, the body temperature was 39.5°C. Physical examination revealed distension and a mass with tenderness in the lower abdomen. Abdominal computed tomography suggested the presence of an ovarian cystic teratoma penetrated into the sigmoid colon, because the tumor had gas, fluid, and a stick shaped high density structure. Emergency drainage under local anesthesia was performed because her general condition was poor. The content of the tumor was fecal juice. After a few days of the drainage she underwent surgery under general anesthesia. The left ovarian tumor and the sigmoid colon were removed because the tumor firmly adhered to the sigmoid colon. The tumor was diagnosed as an ovarian mature cystic teratoma on pathological examinations. Because the fistula between an ovarian tumor and the gastrointestinal tract may cause some severe general complications, we should diagnose and treat it as soon as possible.

Journal

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

    Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 77(10), 2547-2551, 2016

    Japan Surgical Association

Codes

  • NII Article ID (NAID)
    130005628347
  • NII NACSIS-CAT ID (NCID)
    AA11189709
  • Text Lang
    JPN
  • ISSN
    1345-2843
  • NDL Article ID
    027765233
  • NDL Call No.
    Z19-227
  • Data Source
    NDL  J-STAGE 
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