腎盂切石術後にpneumatosis cystoides intestinalisを合併した1例

A CASE OF PNEUMATOSIS CYSTOIDES INTESTINALIS FOLLOWING PYELOLITHOTOMY

はじめに

　Pneumatosis Cystoides Intestinalis　（以下PCIと略す）は病理学的には小腸，大腸の粘膜下または漿膜下に多発性の気腫性嚢胞を呈する比較的稀な疾患である。その臨床症状では明確なものがなく，しばしば腹部単純写真にて横隔膜下にfree airを認めることがあり，消化管穿孔と誤診することがある^1,2）。

　われわれは腎盂切石術後，胸部単純写真にて横隔膜下にfree airを見い出し，消化管穿孔の診断にて開腹手術を行い，PCIと診断した1例を経験したので若干の知見を加え報告する。

A 44-year-old man with a complaint of right lumbago was admitted to our hospital. An IVP and KUB revealed a calcificated density in the right renal pelvis. Under dignosis of right renal pelvic stone pyelolithotomy was done.

The first day of postoperation, the patient complained of abdominal distension. The 4th day, low grade fever appeared. The 7 th day, abdominal plain film revealed free air under diaphragm. Under diagnosis of intestinal perforation emergency operation was done but there was no evidence of perforation.

Only pneumatosis lesion was found at the subserosa of the sigmoid colon.