Fukata Tadafumi, Okimura Shumpei, Ito Yoshiro, Taniguchi Yoshiki, Nishida Hisashi, Shingai Tatsushi, Takayama Osamu, Yoshioka Setsuko, Hojo Shigeyuki, Ohigashi Hiroaki, Fukuzaki Takayuki
Dept. of Surgery, Saiseikai Senri Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2375-2377.
A 75-year-old woman presented with the chief complaint of right lower abdominal pain. There was mild tenderness in the lower right abdomen and a mass was palpated. There were no peritoneal irritation symptoms. A CT examination was performed. The ascending colon was invaginated with a part of the cecum and ileum. Wall thickening was observed in the advanced part. Colon cancer was suspected. The preoperative diagnosis was considered to be an intussusception with cecal cancer at the advanced part. A laparoscopic ileocecal resection was performed. The intraoperative findings were as follows. The tumor was invading the ascending colon, but it was possible to restore it by pressing on the developed part with forceps. The pathological diagnosis was Type 2, muc>tub1, pT4aN0M0, pStageⅡb. The postoperative course was good. Water intake was started on the next day, meals were started from the second day, and the patient was discharged on the 9th day after the operation. Cecal cancer complicated with intussusception is a relatively rare disease. We report a case that was laparoscopically operable.
一名75岁女性因右下腹痛为主诉前来就诊。右下腹有轻度压痛，可触及一个肿块。无腹膜刺激征。进行了CT检查。升结肠套叠，伴有部分盲肠和回肠。在病变进展部位观察到肠壁增厚。怀疑为结肠癌。术前诊断考虑为晚期盲肠癌伴套叠。进行了腹腔镜下回盲部切除术。术中所见如下。肿瘤侵犯升结肠，但通过用镊子按压病变部位可以恢复。病理诊断为2型，黏液>管状1级，pT4aN0M0，pⅡb期。术后病程顺利。术后第二天开始进水，第二天开始进食，患者于术后第9天出院。盲肠癌合并套叠是一种相对罕见的疾病。我们报告一例可通过腹腔镜手术治疗的病例。
