涙囊瘻炎の2例

Infection of congenital lacrimal sac fistula in two cases

要約　目的：無症候性の先天性涙囊瘻に感染を生じた2症例の報告。症例：症例1は23歳女性，症例2は48歳男性で，ともに左眼周囲の腫脹，疼痛を訴え受診された。所見：2例とも左眼の内眼角下方が腫脹し，腫脹部に先天性外涙囊瘻がみられた。涙囊瘻はこれまで無症状であった。上下涙点および涙囊瘻からも涙管通水が良好であったため，急性涙囊瘻炎と診断した。症例1は抗菌薬の投与と腫脹部への穿刺，排膿で，後者は抗菌薬の投与のみで改善した。結論：一見急性涙囊炎と思われても，通水検査や涙囊瘻を確認することで急性涙囊瘻炎ということがあり，先天性外涙囊瘻の存在も念頭に置いて診断する必要がある。

Abstract.　Purpose：To report 2 cases with infected congenital lacrimal sac fistula. Cases：One was a female aged 23 years and the other was a male aged 48 years. Both were unilaterally affected, with pain and swelling as the chief complaints. Findings：Both cases had congenital lacrimal sac fistula that had remained asymptomatic. Irrigation showed patency of lacrimal passage through the upper and lower lacrimal puncta, leading to the diagnosis of infected congenital lacrimal sac fistula. Cure resulted after systemic and topical antibiotics with adjunctive forced irrigation. Conclusion：The present cases illustrate that infection of congenital lacrimal sac ought to be differentiated from acute dacryocystitis, as the two diseases entities need different therapeutic approach.