大腸脂肪腫の3例―とくにwater enema法について

Three Cases of Lipoma of the Colon: with Special Reference to Water Enema Study

　大腸脂肪腫は良性疾患ではあるが本邦においては比較的稀な疾患で，大腸癌・大腸腺腫などとの鑑別診断の点で臨床的に問題となることが多い．著者らは大腸脂肪腫3例を経験し，うち1例にwater enema法を施行したので，water enema法についての考察を加えて報告する．

　Three cases of lipoma of the colon were experienced in our department during the last five years, 1974 to 1978.

　Case 1. A 44-year-old female was admitted with a history of pain in the periumbilical region for a month. An examination revealed a smooth, well-demarcated mass in the sigmoid colon, measuring 2.6cm in diameter. An exploratory laparotomy was carried out and a 2.6×2.6×1.2cm sessile mass was found. The microscopic appearance was that of adult fat cells.

　Case 2. A 67-year-old male was admitted to the department because of diarrhea. An X-ray examination revealed a smooth, ovoid 2.5×3.5 cm mass in the sigmoid colon. An exploratory laparotomy was performed and a pedunculated mass, measuring 2.5×2.5×3.5cm, was found. Microscopic study showed adult fat tissues in the submucosa and there were areas of recent haemorrhage in the mucosa.

　Case 3. A 67-year-old female was admitted to our department with a complaint of watery diarrhea. An X-ray study revealed a 2.2×2.1 cm mass, having smooth margin. Because of the impression of a benign tumor, most likely lipoma, we carried out water enema study. Exposures were made at 60 kV, 80 kV and 110 kV. After water enema study, the mass was demonstrated under the exposure condition of 60 kV and 80 kV. An exploratory laparotomy was performed and a 3.0×3.0×3.0cm yellowish mass was found. Histological diagnosis was that of submucosal lipoma of the colon. The resected specimen was filled with water and roentgenograms were taken at 25 kV and 29 kV. Then, the lipoma was clearly recognized.