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要旨 患者は44歳,女性.近医にて鉄欠乏性貧血,便潜血反応陽性を指摘され,上部消化管内視鏡検査,大腸内視鏡検査を施行されたが,特記すべき異常を認めず,小腸精査目的にて当院を紹介受診した.当院で施行した体外式超音波検査にて小腸に低エコー腫瘤を,小腸造影にて空腸に全周性の潰瘍性病変を,腹部造影CTにて小腸壁肥厚を認め空腸癌が疑われた.ダブルバルーン内視鏡検査にて空腸に不整な潰瘍性病変を認め生検にて空腸癌と最終診断した.
A 44-year-old female was referred to our hospital because of iron deficiency anemia and positive fecal occult blood test. The source of her gastrointestinal bleeding was not revealed by conventional examination such as upper gastrointestinal endoscopy and colonoscopy in the previous hospital. In our hospital, abdominal ultrasonography detected a hypoechoic mass in the small bowel, small bowel enteroclysis revealed an encircling ulcerated lesion in the jejunum, and computed tomography detected wall thickening of the jejunum. The patient underwent double-balloon endoscopy (DBE). We detected an ulcerated mass in the jejunum and biopsy specimens revealed an adenocarcinoma. A preoperative histologic diagnosis of jejunal cancer was able to be made by DBE. Partial resection of the jejunum was performed.
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