空腸平滑筋腫の1例―緊急検査としての小腸内視鏡検査の有用性

Leiomyoma of the Jejunum Diagnosed by Emergency Enteroscopy

　小腸腫瘍のなかで平滑筋腫は決してまれな疾患ではない¹⁾．本症疾患の大半は消化管出血，貧血を主訴とすることが多いが，その術前診断は決して容易ではない，最近，われわれも原因不明の下血を繰り返した本症患者に対して，小腸内視鏡検査によって腫瘍の存在診断がが可能となった1例を経験したので報告する．

　Although leiomyoma of the small intestine is not a rare tumor, satisfactory diagnosis cannot be made preoperatively at all times. A 68-year-old man complaining of recurrent massive melena was admitted to our hospital. He had been repeatedly examined radiologically and endoscopically but the hemorrhagic source had not been diagnosed. Enteroscopy with a sonde-type small intestinal fiberscope (SSIF) was performed immediately a sa screening examination for the massive gastrointestinal bleeding and revealed a whitish tumor floating in the blood at the jejunum. By operation, this tumor, sized 28×25×20mm, was histologically diagnosed as leiomyoma arising from the upper jejunum.

　The Sonde-type small intestinal fiberscope can be inserted into the distal part of the small intestine in a short time without hazard. Therefore, SSIF will be useful as a screening filter of the small intestinal diseases and valuable for the emergency examination of massive intestinal hemorrhage.