小腸内視鏡にて確診しえた原発性空腸癌の1例

Primary Carcinoma of the Jejunum diagnosed by Endoscopy of the Small Intestine

　原発性の小腸癌は，発生頻度も低く，また術前の確定診断は他の消化管の悪性腫瘍に比べて困難とされている^1)～3)．従来はレ線透視のみが有力な診断方法とされていたが，早期小腸癌の診断の難しさはもちろんのこと，かなり進行した小腸癌においても，術前に確定診断を得ることは困難なことがあり^1)2)4)～7)，小腸内視鏡の導入が期待されてきた²⁾．

　著者らは，貧血と下腹部痛を主訴とし来院した40歳男性の原発性空腸癌を術前に確診しえたので報告する．

　A 40-year-old male patient with primary carcinoma of the jejunum, diagnosed endoscopically by using OLYMPUS SIF, is presented. He suffered from the lower abdominal pain, persistent positive occult blood in stools for two months.

　Fluoroscopic examination of the small bowel revealed so called “napkin ring” filling defect in the jejunum 40 cm anal from the ligament of Treitz. Endoscopically, it was a reddish tumor with uneven and unclean ulceration just like Borrmann Ⅱ type of gastric cancer. Endoscopic biopsy specimen from this tumor disclosed well differentiated adenocarcinoma.

　The gross appearance of the tumor, 3.2×3.0 cm in diameters, showed ulceration and invasion to the subserosal fat tissue. No metastasis to the regional lymphnodes or other organs was detected. He is well without any recurrent signs since six months after the operation.