淋菌性腹膜炎が疑われた3例

Three cases in which Neisseria gonorrhoeae was doubted as a cause of panperitonitis

腹膜炎の原因として，淋菌による骨盤内炎症性疾患が疑われた3例を経験した。3例とも急激な腹痛を呈し，腹膜刺激症状陽性であり採血上高度炎症反応の上昇，CTで麻痺性イレウス像を認めた。子宮頸管分泌物より淋菌を検出したため淋菌性腹膜炎が疑われた。抗菌薬治療により3例とも軽快した。過去に淋菌性腹膜炎として報告された症例はすべて外科的手術が行われていたが，今回われわれは保存的に治癒することができたため報告する。

We here report three cases in which Neisseria gonorrhoeae was doubted as a cause of panperitonitis. All cases showed acute abdominal pain. Physical examinations showed symptoms of peritoneal irritation and CT scans revealed paralytic ileus. Neisseria gonorrhoeae was detected by PCR from cervical discharge, so gonococcal panperitonitis was doubted. After antibiotic treatment, all patients were cured and discharged. All reported cases of gonococcal panperitonitis in the Japanese literatures were cured by surgical treatment, but we were able to cure them by antibiotic treatment.