CT enterographyが診断に有用であった原発性小腸癌の1例

Small Bowel Adenocarcinoma Confirmed by Computed Tomography Enterography

要旨●患者は70歳代，女性．14か月前より左下腹部痛が出現し，造影CTにて小腸の限局的な拡張を指摘された．同CTでは腫瘤や閉塞起点は不明であったが，ポリエチレングリコール服用のうえCT enterographyを行ったところ，左側小腸に造影効果のある壁肥厚と，それに連続して腸管内腔を占居する腫瘤を認めた．CT enterographyでは小腸壁が伸展して撮像され，病変部の壁肥厚や造影効果が強調されるため，病変が同定しやすくなったものと考えた．その後，経口バルーン内視鏡検査を施行し，原発性空腸癌と診断した．CT enterographyは，簡便に施行できる小腸検査であり，本症例はその有効性を示したと考え報告する．

　A woman in her 70s had been experiencing lower left abdominal pain for the past 14 months. A contrast-enhanced CT（computed tomography）scan revealed localized small intestinal dilation. A contrast-enhanced CT enterography with polyethylene glycol revealed wall thickening with contrast enhancement on the left side of the small intestine, along with a tumor occupying the intestinal lumen, although the CT scan detected neither tumors nor obstructions. Subsequently, balloon enteroscopy was performed, and the patient was diagnosed with primary jejunal cancer. Thus, CT enterography is a convenient method for evaluating the small intestine, as it distends the small intestinal wall, highlights wall thickening, and demonstrates contrast enhancement of a lesion, thereby facilitating small bowel tumor identification.