回盲部単純性潰瘍の術後再発に対し再度腹腔鏡下手術を行った1例

A case of recurrent ileocecal simple ulcer treated by a second laparoscopic surgery

◆要旨：患者は40歳代の女性．右下腹部痛を主訴とした．2001年初旬より繰り返す回盲部潰瘍を認め，単純性潰瘍と診断されていた．保存的治療に抵抗性であったため，2005年2月に腹腔鏡下回盲部切除を行った．術後1年8か月で再発が確認され，2006年11月に再手術となった．手術は腹腔鏡下結腸右半切除を行ったが，腹腔内に癒着はなく，腹腔鏡下手術における再手術の有用性を証明できた．第5病日目に退院し，術後5か月の現在，再発を認めていない．

　The patient was a woman in her forties who complained of right lower abdominal pain. She had recurrent ileocecal ulcer from early 2001, which was diagnosed as simple ulcer.

　Since the ulcer did not respond to conservative therapy, she underwent laparoscopic ileocecal resection in February 2005.

　The ulcer recurred at 20 months after surgery, therefore, laparoscopic right hemicolectomy was performed in November 2006. At re-operation, there were no adhesions in the peritoneal cavity, which demonstrated the usefulness of the laparoscopic procedure. She was discharged on Day 5 postoperatively and has not experienced any recurrence for five months.