根治的腎摘出術後に発生した腸管嚢腫様気腫症

A Case of Pneumatosis Cystoides Intestinalis after Total Nephrectomy

　腸管嚢腫様気腫症は，小腸または結腸の腸管壁内に含気性嚢胞を形成する稀な疾患である。症例は62歳，女性。健診で尿潜血を指摘され来院した。精査の結果，左腎腫瘍T3aN0M0の診断にて経胸腹的左腎摘出術を施行した。術後の腸蠕動の回復が悪く，12日目より嘔吐，熱発し，イレウスをきたした。腹部CT検査および腸管造影検査にて腸管嚢腫様気腫症と診断された。その後も各種治療に反応せず，敗血症を併発し術後48日目に死亡した。

Pneumatosis cystoides intestinalis (PCI) is a rare disease which is characterized by the presence of submucosal emphysematous cysts. We reported a case of PCI after total nephrectomy. A 62-year-old woman with the com-plaint of microhematuria was diagnosed as left renal cancer (T3aN0M0) and total nephrectomy was performed. After operation the improvement of intestinal peristalsis was poor. Twelve days after nephrectomy she suddenly devel-oped high fever with vomitting and ileus was suspected. PCI was revealed on abdominal CT scan and gastrographic examination.