虫垂腫瘍を疑い腹腔鏡下手術を施行した虫垂憩室症の1例

Diverticulum of the appendix suspected of appendiceal tumor : a case report

◆要旨：虫垂憩室症は比較的稀な疾患であり，術前診断は困難であるとされている．今回，筆者らは虫垂腫瘍を疑い腹腔鏡下に手術を施行した虫垂憩室症の1例を経験したので報告する．患者は61歳，男性．右下腹部の違和感を主訴に受診した．CT検査で虫垂の腫大および璧肥厚を認めた．確定診断はつかないものの虫垂の腫瘍性病変を疑い，腹腔鏡補助下回盲部切除術を施行した．病理組織学的検査では筋層を欠く仮性憩室が多数認められ，虫垂仮性憩室症と診断した．術後の合併症はなく経過し，第8病日目に退院した．虫垂憩室症に対する腹腔鏡下切除術は術後疼痛の軽減および早期の日常生活復帰などの点できわめて有用であると考えられた．

　Diverticulosis of the appendix is a relatively rare condition, and its preoperative diagnosis is difficult. We herein report a patient with diverticulum of the appendix that was suspected of being an appendiceal tumor preoperatively and was resected by laparoscopic surgery.

　A 61-year-old man was referred to our hospital because of the discomfort in the right lower abdomen. Abdominal CT revealed swelling and wall thickness of the appendix. Due to the possibility of malignant appendiceal tumor, we performed ileocecal resection by laparoscopic surgery. Histopathological examination revealed numerous false diverticula lacking muscular layers in the diverticular wall. Postoperative course was uneventful, and he was discharged on the 8 th postoperative day. Laparoscopic surgery is thus considered to be an effective method to treat diverticulum of the appendix.