| S状結腸絞扼性イレウスの1例. A case of postoperative strangulating obstruction of the sigmoid colon | |||||||||||||
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Abstract | |||||||||||||
| 今回我々はS状結腸絞扼性イレウスの1例を経験したので報告する。症例は40歳の女性。腹痛を主訴に当院に緊急入院となった。腹部レントゲンで拡張した大腸ループ像を認めた。造影CTでは捻れ像をともなわない二重に拡張したS状結腸を認めた。開腹手術にて子宮とS状結腸との間の癒着性のヒモに起因するS状結腸絞扼性イレウスの診断となった。S状結腸に発生する絞扼性イレウスはS状結腸軸捻症との臨床像が類似していることから診断が非常に困難である。しかし虚血を引き起こす病態であり, 早期診断と早期開腹手術が必要であると思われる。本疾患の報告はこれまでになく自験例が1例目であったので, 文献的考察を加え報告する。. We present a case of strangulating obstruction of the sigmoid colon. A 40-year-old female was admitted to our hospital with abdominal pain. Plain radiograph of the abdomen showed distended closed colon loops, and enhanced CT demonstrated a distinctive double-dilated loop of sigmoid colon without torsion. Upon laparotomy, we observed an adherent band coursing from the mesenterium of the sigmoid colon to the scar at the fundus of the uterus where the enucleation of myoma uteri had been performed. Strangulating obstruction occurs often in small intestine. However, that of the large intestine, especially that of sigmoid colon is extraordinary and difficult to be distinguished from sigmoid colon volvulus which has similar clinical features. Strangulating obstruction of the sigmoid colon causes ischemia, and therefore early diagnosis and laparotomy are required. This quite uncommon disease has not been reported previously, and our case will be the first report. We discuss the clinical features of this rare disease with reference to the literature. | |||||||||||||
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