胃静脈瘤を有したバンチ症候群患者の1例

A Case of Banti's Syndrome with Gastric Varices which showed a Marked Filling Defect of Cardia resembling Malignant Tumor

　胃静脈瘤は決してまれなものではなく，出血の部位として重要であることが指摘されている¹⁾²⁾．Samuel³⁾は胃静脈瘤が食道静脈瘤に先行すると結論している．しかも静脈瘤が噴門部のみに発生し食道にない場合には，噴門部腫瘍との鑑別が困難であると，一般にいわれている．

　筆者らは著明な噴門部陰影欠損を示した胃静脈瘤を伴うバンチ症候群の1例を経験したので，報告し，参考に供したい．

　Gastric varices are encountered not rarely, and many authors point out they are one of the important sources of hemorrhage.

　The authors have recently found a case with gastric varices which showed a marked filling defect of cardia on roentgenographic examination.

　Case: A 55-year-old woman was admitted to the hospital on May 9, 1968, because of anemia and general weakness.

　She had no past history of hematemesis and melena.

　She was pale, emaciated, chronically ill and lying in bed, with marked splenomegaly.

　The laboratory examination revealed hypochromic microcytic anemia, leucopenia, low serum iron value and low serum A/G ratio.

　The roentgenographic examination of the upper gastrointestinal tract revealed a marked filling defect of the cardia.

　During the three months of hospitalization, she had experienced seven episodes of hematemesis and melena.

　Surgical exploration revealed marked gastric varices and splenomegaly.

　The portal pressure was 280 mm of saline. The splenectomy was performed.

　The spleen weighed 530 g. Microscopical finding of the spleen revealed the typical picture of Banti's syndrome.

　The postoperative course was uneventful. She had been in good condition until June 18, 1969, when she had an other episode of hematemesis and melena.

　Proximal gastrectomy and pyloroplasty were performed on July 2, 1969.

　The second postoperative course was relatively uneventful. Since then, she has had no further hemorrhage for six months.