回腸inflammatory fibroid polypの1例

Inflammatory Fibroid Polyp of the Terminal Ileum, Report of a Case

　良性の炎症性腫瘤と考えられている消化管のinflammatory fibroid polypは，胃における報告例が多いが，小腸のものは少なく，本邦では今までに10例報告されているにすぎない．最近，われわれは回腸末端部に発生し，回盲部腸重積を呈した本疾患の1例を経験したので報告する．

　Inflammatory fibroid polyp of the small intestine is a rare lesion. As far as we know, only 10 cases have been reported in Japan. This is the eleventh report of this disease in Japan, we think.

　A 40 year-old woman was admitted to our hospital due to right lower abdominal pain. The onset of the symptom dated back to six months ago. As she had noticed dark red stool from one to three times a day about a week before and then complained of severe right lower abdominal pain, she came to our hospital. She had no particular past and family histories. Physical examination revealed only right lower abdominal tenderness with resistance. All the indicated laboratory studies were within normal limits except positive occult blood test and mild anemia.

　By colonofiberscopy immediately after her admission, a subpedunculated polypoid lesion at the ascending colon was shown. It had a slightly irregular surface with mild hemorrhage on its top and the smooth surface on its base.

　Double contrast barium enema showed a filling defect covered with Kerckring folds incarcerated in the ascending colon. It was an intussusception caused by a polypoid lesion of the terminal ileum. The intussusception was spontaneously reposited.

　Partial resection of the terminal ileum was performed. The polypoid lesion was 2.0×2.0×3.0 cm in size, about 15 cm proximal to the ileocecal valve.

　As the lesion consisted of hyperplasia of fibrous tissue and the infiltration of eosinophils and other inflammatory cells histologically, we diagnosed this lesion as an inflammatory fibroid polyp of the terminal ileum.