比較的稀な腫瘤形成型大腸小腸結核の1手術治験例

A Rare Case of Hypertrophic Tuberculosis of Colon and Ileum

　近年化学療法の発展その他の影響で，腸結核の報告も減少しているが最近われわれは回腸と右結腸曲に発生した腫瘤型腸結核の1例を手術治癒し得たので報告する．

　A 66-year-old woman came to our hospital with complaints of appetite loss, sense of fullness in the abdomen, and epigastric pain all of 5 years' duration.

　The films of colon revealed a narrowing at the right colic flexure with irregular serrated margin, and on the double contrast radiography an uneven reticular radiolucent mucosal pattern was visualized.

　Under the preoperative diagnosis of regional colitis the patient was operated on. Two big tumors, both measuring 5×5×6 cm, were f ound, the one at the right colic flexure and the other in the ileum, 40 cm oral from the ileum-end. The colon and ileum were resected including two tumors together followed by ilecocolostomy.

　Histologically the tumors were hypertrophic tuberculosis of the colon and ileum which had typical tuberculous nodules, and tubercle bacillus was found at the bottom of tuberculous ulcer.

　The postoperative condition was very good and she is doing very well now one year after the operation.

　Nowadays intestinal tuberculosis is one of rare diseases. This case is especially so because hyperplastic tuberculosis arose in the small intestine without tuberculous lesion in the cecum where almost all intestinal tuberculosis arise.