Ikeuchi Kyoko, Torii Ayao, Kurita Akira, Yamashita Yoko, Aihara Kensaku, Matsubara Susumu, Hamada Akihiko, Endou Yoko, Takeda Yasuhiro, Yamakawa Masashi, Nisikawa Atsuhiro, Noguchi Masashi
Digestive Disease Center, Kyoto-Katsura Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2006 Apr;103(4):415-9.
A 33-year old woman was referred to our hospital because of gradually progressing abdominal pain and abdominal distension. A computed tomography demonstrated that distended cecum was located in the left retroperitoneal space. Barium enema revealed that the descending colon was positioned at the right side of the abdomen and transverse colon became severely tapered. Ceacal volvulus in addition to the internal herniation into the left retroperitoneal space was clinically diagnosed. The patient received an emergent operation. Operative findings showed that mesenterium commune, no fixation of the colon to the retroperitonium, and the internal herniation of terminal ileum to transverse colon into the sigmoid mesentery. Moreover, the cecal volvulus was diagnosed at the left retroperitoneal space. The mesenterium commune with internal herniation and cecal volvulus is extremely rare but one of important causes of acute abdomen.
一名33岁女性因腹痛和腹胀逐渐加重被转诊至我院。计算机断层扫描显示扩张的盲肠位于左腹膜后间隙。钡剂灌肠显示降结肠位于腹部右侧，横结肠严重变细。临床诊断为盲肠扭转并伴有向左腹膜后间隙的内疝形成。患者接受了急诊手术。手术所见显示存在共同系膜，结肠未与腹膜后固定，以及回肠末端经横结肠向内疝入乙状结肠系膜。此外，在左腹膜后间隙诊断出盲肠扭转。伴有内疝和盲肠扭转的共同系膜极为罕见，但却是急腹症的重要原因之一。
