先天性涙囊ヘルニアに対し23G注射針つき注射筒を用いた1例

Aspiration of congenital dacryocystocele using a 23-gauge needle

要約　目的：新生児の先天性涙囊ヘルニアに対し，23G注射針で穿刺し，内容物を吸引した報告。

症例：在胎40週の自然分娩で生まれた女児に，出生直後から左の内眼角下方に3mm×3mm大の弾性軟で青灰色の膨隆と眼脂があった。生後20日目に直視下で経皮的に23G注射針っきの注射筒で囊腫を穿刺し，内容物を0.7ml吸引した。7日後の再診時に内眼角部の膨隆は消退していたが，鼻内視鏡で下鼻道に囊腫の再発があった。鼻内視鏡下でメスで囊腫を切開し，漏出した内容物を吸引した。以後，再発はない。

結論：先天性涙囊ヘルニアに対する23G注射針による穿刺と吸引の効果は一過性であった。

Abstract　Purpose: To report a neonatal case who received puncture and aspiration of cyst of nasolacrimal duct with a 23-gauge needle.

Case: A female baby showed lacrimal discharge and swelling inner to the medical canthus in the left eye. The swelling was grayish blue and was 3 mm by 3 mm in size. The condition was diagnosed with dacryocystocele. The cyst was punctured and aspirated with a 23-guage needle on day 20 after birth. Nasal endoscopy showed recurrence of the cyst when seen one week later. The cyst was resected with a knife transnasally. There has been no recurrence until present.

Conclusion: Puncture and aspiration with a 23-gauge needle was of temporary effect for dacryocystocele in a baby.