腸閉塞を呈した回腸血管腫について

A CASE OF HEMANGIOMA WHICH HAS SHOWN THE SYMPTOM OF ILEUS.

Ⅰ．緒言

　小腸の良性腫瘍は比較的まれなものであり，主としてポリープ，腺腫や脂肪腫である．血管腫はきわめてまれで，その内の5～9％を占めるに過ぎない．欧米においてもRiverの集計では1956年まで小腸良性血管腫は127例であり¹⁾，1962年Reifferscheidは悪性のものも含めて337例をまとめている²⁾．本邦においては小腸の良性血管腫はまだ9例が報告されているのみであり，血管腫によって誘発された腸重積の症例はわずか3例である³⁾．しかし血管腫によって起った狭窄のために腸閉塞を招来した症例は未だ報告されていない，

　われわれは最近腸閉塞症状をおこし，その原因が回腸の毛細血管腫による狭窄であると考えられる症例を経験したので紹介する．

　Benign tumors of the small intestine are comparatively rare and they are mainly polyp, adenoma and lipoma.

　Hemangioma is very rare and its percentage among all the cases is five to nine per cent. In our country, nine cases of hemangioma in the small intestine were found and only three cases showed intestinal invagination. This is the first of the case of hemangioma in the small intestine that obstructed the lumen and became the cause of ileus. The patient was 66 year old male. Epigastric pain had appeared six days before the admission. Nausea and vomiting were seen. The pain increased and spread all over the abdomen gradually.

　The swelling of the abdomen increased also and no flatus came out since the morning of the day of admission. He had no hematemesis and melena. On the X-ray examination, ileus symptom at small intestine was recognized and the operation was performed immediately. At laparotomy the site of stenosis was noticed at 50 cm from ileum end. This was capillary hemangioma at subserous and muscle layer accompanied with hemorrhage.

　The diffuse polymorph neutrocyte infiltration was noticed at subserous layer. On the pathological diagnosis, it was capillary hemangioma of the ileum restricted to the subserous and muscle layer with an acute inflammation. Postoperative course was uneventful and the patient was discharged 19 days later. Some investigation into and study about documents were also made.