十二指腸癌，肝転移と合併した特発性腸間膜静脈硬化症の1例

Idiopathic Mesenteric Phlebosclerosis with Duodenal Cancer, Report of a Case

要旨　患者は74歳，女性．右下腹部痛にて近医で注腸造影検査を実施したところ，異常を指摘され当科を受診した．注腸造影では虚血性腸炎に類似した所見，腹部CT検査にて上行結腸を中心に石灰化を認めた．大腸内視鏡検査では粘膜は暗紫色，浮腫状を呈しており，同部位からの生検にて粘膜内と粘膜下の静脈壁の肥厚とフィブリン滲出物を認めた．これらの所見より特発性腸間膜静脈硬化症と診断した．また，本症例は十二指腸癌と転移性肝腫瘍を認めた．本疾患はまれであり，文献的考察を踏まえて報告する．

　The case is that of a female of 74 years of age. An abnormality was noted when a family doctor had a barium enema radiograph carried out for right lower abdominal pain and a checkup performed in our department. Barium enema findings showed similar evidence as found in ischemic colitis. Calcification was revealed by CT examination mainly on the ascending colon. The mucosa appeared as a dark purple form of edema by colonoscopic examination, and biopsy from the part showed fibrin exudate and hypertrophy in the mucosa and a submucosal vein. From this evidence, we diagnosed it as idiopathic mesenteric phlebosclerosis. In addition, in this case, duodenal cancer and multiple metastatic liver tumors were recognized.

　This is a rare disease, so we report our discussion based on the literature.