Wakahara T, Kusaka Y, Yoshida H
Dept. of Surgery, School of Med., Iwate Medical Univ.
Gan No Rinsho. 1988 Jan;34(1):107-10.
Recently encountered is a case of a primary ileal carcinoma in which radical resection was performed. The history follows. A 76-year-old male was admitted to Miyako Hospital on January 12, 1986 complaining of abdominal pain of ten days duration. Pre-operative treatment extended over an eleven-day period without any symptomatic remission. A barium enema and roentgenographic examination that followed a barium ingestion revealed no abnormality in the large bowel, but a mechanical obstruction, typical of a carcinoma, was detected in the small intestine. On January 23, 1986, under a general anesthesia, the abdomen was opened through a midline rectus incision. A tumor was found in the terminal ileum 14 cm proximal to the ileocecal valve, and was causing almost total obstruction of the intestine. This tumor, with involved ileal and regional lymph-nodes, was resected, followed by an end-to-end anastomosis. The tumor, grossly circumscribed, was roughly circular in outline and protruded from the ileal wall. No lymph-node metastasis was found in histological sections. The diagnosis was a primary adenocarcinoma of the ileum. Few reports have been reported in Japan on radically resected primary carcinomas of the ileum. The future course of this case deserves careful study.
最近遇到一例原发性回肠癌患者，已行根治性切除术。病史如下。一名76岁男性于1986年1月12日因持续10天的腹痛入住宫古医院。术前治疗持续了11天，症状未缓解。钡剂灌肠及吞钡后的X线检查显示大肠无异常，但在小肠发现了典型的癌性机械性梗阻。1986年1月23日，在全身麻醉下，经腹直肌正中切口打开腹腔。在距回盲瓣近端14 cm的回肠末端发现一个肿瘤，几乎完全阻塞了肠道。该肿瘤连同受累的回肠及区域淋巴结被切除，随后进行端端吻合。肿瘤肉眼边界清晰，轮廓大致呈圆形，从回肠壁突出。组织学切片未发现淋巴结转移。诊断为原发性回肠腺癌。在日本，关于根治性切除的原发性回肠癌的报道很少。该病例的未来病程值得仔细研究。
