Kawai Kenji, Murata Kohei, Kagawa Yoshinori, Naito Atsushi, Takase Kouki, Mori Ryota, Nose Yohei, Sakamoto Takuya, Murakami Kohei, Katsura Yoshiteru, Omura Yoshiaki, Masuzawa Toru, Takeno Atsushi, Takeda Yutaka
Dept. of Surgery, Kansai Rosai Hospital.
Gan To Kagaku Ryoho. 2019 Feb;46(2):291-293.
The patient was a 67-year-old female without a history of surgery. She presented with an abdominal pain and vomiting, and was rushed to our hospital. The abdominal pain was severe, but no peritoneal irritation sign was observed. Abdominal CT scan revealed a strangulating intestinal obstruction and accumulation of ascitic fluid. Emergency surgery was performed for diagnosis and treatment. The intraoperative finding showed serous ascitic fluid and strangulating intestinal obstruction caused by appendiceal tumor coiling around the terminal ileum, which had become ischemic with thinning of its wall. Ileocecal resection with removal of lymph nodes(D3)was performed. The postoperative course was uneventful, and the patient was discharged 13 days after the surgery. Pathological examination of the appendiceal tumor revealed a low-grade appendiceal mucinous neoplasm(LAMN)with no metastasis to the lymph nodes. We had a rare case of strangulating intestinal obstruction caused by coiling of LAMN to the terminal ileum.
该患者为67岁女性，无手术史。她因腹痛和呕吐前来就诊，并被紧急送往我院。腹痛剧烈，但未观察到腹膜刺激征。腹部CT扫描显示绞窄性肠梗阻和腹水积聚。为明确诊断和进行治疗，实施了急诊手术。术中发现为浆液性腹水以及由阑尾肿瘤缠绕回肠末端导致的绞窄性肠梗阻，回肠末端已缺血且肠壁变薄。进行了包括淋巴结清扫（D3）的回盲部切除术。术后过程顺利，患者术后13天出院。阑尾肿瘤的病理检查显示为低级别阑尾黏液性肿瘤（LAMN），无淋巴结转移。我们遇到了一例罕见的由LAMN缠绕回肠末端导致的绞窄性肠梗阻病例。
