Skip lesionを呈した腸間膜脂肪織炎の1例

Mesenteric Panniculitis Showing Skip Lesion, Report of a Case

　腸間膜脂肪織炎（mesenteric panniculitis）は極めてまれな疾患である．われわれは空腸にskip lesionを呈した本疾患を経験したので文献的考察を加え報告する．

　A 63 year-old man was admitted to Akita University Hospital because of abdominal fullness and vomiting. Physical examination revealed the tenderness in the left paraumbilical region. Small bowel study showed the dilatation of the duodenal loop and skipped narrowing in the upper jejunum. The distal narrowed segment was interpreted as the longitudinal ulceration. Selective angiography of superior mesenteric artery showed the irregularity and tortuosity of vasa recta.

　Laparotomic findings showed the dilation of the stomach and duodenum, and markedly thickened jejunal mesenterium with multiple nodular formation. Segmental resection of the jejunum and jejuno-jejunostomy were performed. Histologically, focal necroses of the adipose tissue with the infiltration of lymphocytes, plasma cells and histiocytes with lipophage were noted.

　In addition, mesenteric venous thrombosis and perivascular fibrosis in the jejunal mesenterium were seen.