腹腔鏡下にて切除しえた特発性腸間膜血腫の1例

Spontaneous mesenteric hematoma treated by laparoscopic resection : a case report

◆要旨：患者は68歳，男性．近医にて腹部腫瘤を指摘され，精査加療目的にて当院に入院した．腹部CTおよびMRIにて腹腔内に径3cm大の境界明瞭な内部不均一な腫瘤を認めた．良性の腹腔内囊胞性腫瘤と判断したが悪性の可能性も否定できないために手術を施行した．上行結腸間膜内に腫瘤は存在しており，腹腔鏡下にて腫瘤を摘出した．病理組織学的検査で悪性所見はなく血腫の診断であり，外傷の既往もないことから特発性腸間膜血腫と診断した．術後は良好に経過し，第7病日に退院した．特発性腸間膜血腫は稀な疾患であり，若干の文献的考察を加え報告する．

　A 68-year-old man was found to have an abdominal tumor at another hospital and he was admitted to our hospital. Abdominal computed tomography （CT） and magnetic resonance imaging（MRI） revealed a well defined, heterogeneous tumor measuring 3 cm in diameter. We suspected benign intra-abdominal cystic tumor, but the possibility of malignant tumor could not be ruled out, and we performed laparoscopic tumor resection. Histopathological examination showed no signs of malignancy and the cystic tumor was diagnosed as a mesenteric hematoma. He had no history of abdominal trauma. We diagnosed the hematoma as spontaneous mesenteric hematoma. The postoperative course was uneventful and he was discharged from the hospital on the 7th postoperative day. Since spontaneous mesenteric hematoma is rare, we report on this case with some bibliographical comments.