下血を機に発見された空腸リポーマの1例

Small Jejunal Submucosal Lipoma with Melena

　小腸の良性腫瘍は極めてまれな疾患であり，しかも症状発現の頻度も少なく，狭窄，重積，出血などの合併症が出現してはじめて発見される症例が大多数であるため十分な検査された症例は数少ない．

　われわれは，原因不明の下血のため繰り返し消化管精査を行っているうち，たまたま比較的小さな空腸のリポーマを発見し術中の内視鏡検査をも行ったので，若干の検討を加え報告する．

　A case with a lipoma of the jejunum manifesting massive melena was reported. The tumor was a finger-like protrusion with a smooth surface measuring 3×1.2cm and had no ulceration. Histologically it was a submucosal lipoma.

　In the course of investigation, few adenomas of the colon was found, and a tiny ectopic pancreas of the jejunum was accidentally recognized during the intraoperative endoscopy. However, these tumors including the jelunal lipoma were not the source of melena. The cause of melena still remains obscure. Conv wentional barium follow-through study of the small intestine had no diagnostic value in detecting the tumor of this patient.

　For the diagnosis of small intestinal tumors, compression study and double contrast study seem to have a great diagnostic value. In the case of need, intraoperative endoscopy may be of value.