小腸癌の1例

Cancer of the Small Intestine, Report of a Case

　小腸に原発する癌腫はまれなものであり，本邦において過去10年間に報告されたものでさえも，次頁，表1のごとくである．

　筆者らはX線診断およびR.Ⅰ検査によって空腸癌と診断し，手術により確認し得た症例を経験したので報告する．

　Carcinoma arising primarily out of the small intestine is of such a rare occurrence that only a few cases have been reported so far in our country. The case here described was preoperatively diagnosed as carcinoma of the jejunum by both x-ray and RI examinations and was confirmed as such after the surgical intervention.

　The patient, a 63-year-old man, was admitted to the hospital with complaints of abdominal pain on the right side and a tumor-like mass he had noticed there. X-ray examination of the upper digestive tract showed no abnormality. Hypotonic duodenography then revealed a stricture in the jejunum beyond the Treiz' ligament. For elucidating the exact nature of the constriction we employed a double contrast study of the small intestine by using an intestinal probe. It revealed a constriction in a segment of the jejunum beyond the Treiz' ligament, with resultant dilatation of the segments above it. The narrowing extended over the whole circumference of the wall, and a shadow defect with rigid margins was observed there. The constricted part was scanned 48 hours after intravenous injection of 2 mCi ⁶⁷Ga-citrate. The scan showed its definite selectivity in the site corresponding to the stricture.

　Surgical intervention revealed an almost spherical tumor in the jejunum about 28 cm beyond the Treiz' ligament, correpsonding well with the site of narrowing as seen by x-ray. Its serosal side was protruded. Histologically, it was adenocarcinoma of the jejunum.