空腸平滑筋腫の3例

Leiomyoma of the Jejunum, Report of Three Cases and Review of Japanese Literature

　小腸腫瘍は比較的まれな疾患と言われているが，われわれは最近3例の空腸平滑筋腫を経験したので報告する．

　Case 1: The patient was a 49-year-old man who came in to our hospital for full investigations of recurrent bouts of upper abdominal pain. The patient was shown by x-ray to have intussusception of the jejunum owing to a submucosal tumor, and he was referred to surgery. The pathological diagnosis of the tumor was leiomyoma of intraluminal type and it was of interest that the tumor was divided into three nodules by connective tissue.

　Case2: The patient was a 54-year-old man who was admitted to our hospital with intermittent episodes of melena, and the barium meal study of the small intestine showed a tumor at the duodeno-jejunal flexure. Postoperatively, he was found to have leiomyoma of intra-and extraluminal type with fistula formation.

　Case3: A39-year-old woman was urgently admitted to our hospital with clinical symptoms of intestinal ohstruction. Intussusception of the jejunum was visualized by x-ray and the cause of intussusception was a polypoid tumor which was later confirmed to be a leiomyoma of intraluminal type.

　A total of 551 patients with benign tumor of the duodenum and small intestine have been reported in Japan between 1970 and 1979. Leiomyoma, which was the commonest benign tumor, was encountered in 153 out of the 551 patients. The average age of the 153 patients was 52.3 years with a male to female ratio of one to one. The commonest chief complaint was gastrointestinal bleeding or anemia (66.1%) but 1.6% of the 153 patients were asymptomatic.