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A Case Regarded as Gardner's Syndrome A. Imamura 1 , K. Aikawa 1 , S. Tanaka 2 , M. Yagi 4 , S. Ikeda 5 1Division of Gastroenterology, National Sapporo Hospital, Hokkaido Cancer Center 2Division of Surgery, National Sapporo Hospital 4Division of Oral Surgery, Dept. of Dentistry 5Ikeda Gastroenterological Clinic pp.1223-1229
Published Date 1979/9/25
DOI https://doi.org/10.11477/mf.1403107765
  • Abstract
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 A case of colo-rectal adenomatosis associated with multiple lesions at the duodenum and jejunum, occult osteomas at the mandible and dental anomalies, and a subcutaneous hemangioma, is reported.

 A 19-year-old man was first seen at our hospital on May 9, 1976, because of shortness of breath and bloody stool.

 Barium enema demonstrated numerous polyps and the specimen excised by endoscopic polypectomy showed adenoma, therefore he was admitted under the diagnosis of colo-rectal adenomatosis on May 30, 1976.

 There was a negative family history, though upper G.I. series with small bowel follow-through, bariumenema, roentgenogram of the general bones and dental examination were performed for his patients and sister, and only history-taking from paternal and maternal grandparents. Therefore this case is thought to be nonfamilial case at present.

 As gastro-intestinal lesions besides colon and rectum, there was no evidence of esophageal and gastric lesions, but hypotonic double contrast study of the duodenum and upper jejunum demonstrated multiple minute protruded lesions, and endoscopic examination of the second portion of the jejunum revealed multiple small yellow-white protruded lesions. Biopsy specimen from these lesions showed an evidence of adenoma.

 Only 32 cases, associated with lesions of the small bowel, has been reported so far.

 Total colectomy with ileostomy was performed on Oct. 27, 1977. Macroscopical findings of the resected specimen showed non-carpeted type, and microscopically 3 adenocarcinomas were noted.

 As other associated lesions, so-called occult Osteomas at the mandible and dental anomalies, subcutaneous capillary hemangioma were noted. In addition, lymphfollicular hyperplasia of the terminal ileum was also found.


Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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