イレウスを呈した骨盤内臓全摘術後人工肛門癌の1例  [in Japanese] A Case of Ileus Due to Adenocarcinoma Arising at a Colostomy Site after a Surgical Treatment for a Rectosigmoid Cancer  [in Japanese]

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Abstract

<p>人工肛門癌は非常に稀な疾患で報告は少ない.今回われわれは直腸S状部癌術後の人工肛門癌によるイレウスの1例を報告する.症例は54歳の男性.膀胱と回腸に浸潤した直腸S状部癌にて骨盤内臓全摘術および回腸部分切除術が施行された.術後9カ月目に人工肛門部に腫瘍がみられるようになり,CT検査で腹膜播種,リンパ節転移,腹直筋転移が認められた.さらに2カ月後に腹痛を発症し,結腸の拡張がみられた.人工肛門に癌がみられ,そのすぐ奥で狭窄が存在し,結腸イレウスを発症していた.人工肛門に発生した再発癌が化学療法によって縮小し,結腸狭窄をもたらしイレウスが発症したと考えられた.手術は横行結腸人工肛門造設術を施行した.術後2週間で化学療法を再開し,人工肛門癌は縮小した.人工肛門癌によるイレウス症例は,会議録を含めて検索したが本邦では認められなかった.</p>

<p>Cancer arising at a colostomy site is rare and few cases have been reported. Here, we report a case of ileus due to adenocarcinoma arising at a sigmoid colostomy site after a surgical treatment for rectosigmoid cancer. A 54-year-old man underwent total pelvic exenteration and resection of ileum for rectosigmoid cancer invading bladder and ileum. Nine months after surgery, a tumor was seen at the sigmoid colostomy site, and CT findings showed peritoneal dissemination and metastases of lymph nodes and rectus abdominis muscle. Two months later, abdominal pain occurred and dilatation of colon was observed. A cancer was seen at the colostomy site, stenosis was observed just oral side of the colostomy, and it caused ileus of colon. It was thought that recurrent cancer at the colostomy site was reduced by chemotherapy, which caused stenosis of colon and ileus. We created transverse colostomy because of obstruction. Chemotherapy was resumed two weeks after the operation, and cancer at the colostomy site was reduced. This is the first case of ileus caused by cancer occurring at the colostomy site in Japan.</p>

Journal

  • Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons)

    Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 41(6), 981-988, 2017

    Japanese College of Surgeons

Codes

  • NII Article ID (NAID)
    130006294370
  • Text Lang
    JPN
  • ISSN
    0385-7883
  • Data Source
    J-STAGE 
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