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Rectal Tumor with Severe Fluid and Electrolyte Depletion, Report of a Case and Review of 20 Cases with Electrolyte Depletion Syndrome in Japan Shuichi Iwatani 1 , Takahiro Kojima 1 , Seiichi Takenoshita 1 , Hiroshi Kimura 1 , Yukio Nagamachi 1 1First Department of Surgery, Gunma University School of Medicine Keyword: 意識障害 , 粘液便 , 脱水 , 粘液癌 , 絨毛腺腫 pp.1455-1460
Published Date 1990/12/25
DOI https://doi.org/10.11477/mf.1403111767
  • Abstract
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 Fluid and electrolyte depletion is caused by the increased secretory activity of a vinllus tumor. We encountered such a case of rectal cancer with electrolyte depletion syndrome.

 A 74-year-old female patient was admitted to a hospital in January, 1988, complaining of disturbance of consciousness and severe watery mucus diarrhea. A huge tumor was found in the rectum by digital examination and she was transferred to our hospital in April, 1988. Clinical examination showed a great amount of dehydration and azothemia. Particularly, electrolyte imbalance was noted at Na+120, C1-77, and K+ 3.6 mEq/l (Fig. 1). Contrast enema by using gastrographin revealed a huge tumor with shaggy nap features on the rectum (Fig. 2). Endoscopic study showed whitish granulated surface of the tumor (Fig. 3). Miles' operation was undertaken after fluid and electrolyte replacement had been carried out. Postoperatively, evacuation of large amounts of mucus-containing fluid ceased and her consciousness became entirely clear.

 Surgical specimen showed an ulcerated type vinllus tumor with carcinoma in the rectum, 15×15 cm in size (Fig. 4). Histological investigation showed vinous adenoma with well-differentiated adenocarcinoma and mucinous carcinoma (Fig. 6).

 Villous tumor with electrolyte depletion syndrome is rare in Japan. Only 19 cases have been reported and ours is the twentieth case.


Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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