Sumi K, Kaibara N, Koga S
First Department of Surgery, Tottori University School of Medicine, Yonago, Japan.
Jpn J Surg. 1989 Nov;19(6):747-50. doi: 10.1007/BF02471727.
A 55-year-old woman presented to our hospital with abdominal fullness and edema of both legs. She had undergone a bypass operation by an ileotransversostomy for adhesive ileus following a drainage operation for acute appendicitis 35 years previously. We diagnosed the patient as having blind loop syndrome as a consequence of the side-to-side ileotransversostomy, and performed a right hemicolectomy and intestinal resection. The resected specimen of dilated ileal blind loop contained 15 crater-like lesions, proven histologically to be nodular proliferation of atypical lymphocytes. Lymph follicles had also proliferated in the mucosa of the blind loop and the histologically confirmed diagnosis of non-Hodgkins lymphoma of the diffuse medium-sized cell type was thus made. The etiology of such tumors is probably related to the alteration in intestinal environment caused by conditions such as fecal stasis, bacterial overgrowth, and bacterial toxins in the blind loop.
一名55岁女性因腹胀和双下肢水肿前来我院就诊。35年前,她因急性阑尾炎行引流术后,因粘连性肠梗阻接受了回肠横结肠吻合术。我们诊断该患者因回肠横结肠侧侧吻合术导致盲袢综合征,并进行了右半结肠切除术和肠切除术。切除的扩张回肠盲袢标本中有15个火山口样病变,经组织学证实为非典型淋巴细胞结节性增生。盲袢黏膜中的淋巴滤泡也有增生,因此组织学确诊为弥漫性中等大小细胞型非霍奇金淋巴瘤。此类肿瘤的病因可能与盲袢内粪便淤滞、细菌过度生长和细菌毒素等情况引起的肠道环境改变有关。