Idiopathic myointimal hyperplasia of the mesenteric vein（IMHMV）による狭窄型虚血性大腸炎の1例（二次出版論文）

Stenotic-Type Ischemic Colitis in the Sigmoid Colon and Rectum with Narrowing of the Mesenteric Vein：A Case Study:Secondary Publication

要旨●患者は72歳，男性．突然の便秘と水様性下痢を主訴に当院内科を紹介され受診となった．S状結腸〜直腸に及ぶ狭窄型虚血性腸炎の診断となった．CTにて腸間膜静脈主幹部の著明な狭小化を認め，大腸の血流は拡張した辺縁静脈を介して門脈に流入していた．外来にて5か月間経過観察されたが，症状の改善なく，腹部膨満感，排便切迫症状も出現し，外科紹介となり，腹腔鏡下に狭窄を来していたS状結腸直腸を切除した．術後の病理学的所見によりidiopathic myointimal hyperplasia of the mesenteric veinsの診断となった．術後4年経過したが，症状の再燃なく経過は順調である．

　A 72-year-old man suddenly became constipated and suffered a bout of watery diarrhea in small mounts. He was referred to our hospital and diagnosed with stenotic-type ischemic colitis of the sigmoid colon and rectum. Abdominal computed tomography revealed constriction in the superior and inferior mesenteric veins, with blood flow from the entire colon and rectum redirected via the dilated marginal vein into the portal vein. Although he was followed up at our outpatient clinic for 5 months, his constipation and a bout of diarrhea showed no improvement. As he finally complained of abdominal distension and defecation urgency, he was referred to general surgery for surgery. He had to undergo laparoscopic resection of the sigmoid colon and the rectum, which was exhibiting stenosis. The pathological diagnosis of this specimen showed idiopathic myointimal hyperplasia of the mesenteric veins of the sigmoid colon and rectum. Four years have passed since surgery, and no recurrence has been observed for the moment.