腹腔鏡下に切除した虫垂腺腫による虫垂重積症の1例

Laparoscopically resected appendiceal intussusception caused by adenoma

◆要旨：患者は55歳の男性．検診で便潜血陽性を指摘された．大腸内視鏡検査で上行結腸にIsp型のポリープを認め，それと連なるようにして虫垂が盲腸内に引き込まれていた．腹部CT検査では上行結腸内に造影される腫瘤像を認めた．ポリープは生検により腺腫と診断された．虫垂腺腫による完全型の虫垂重積症と診断し，腹腔鏡補助下にD2郭清を伴う回盲部切除術を施行した．術後経過は良好で第8病日に退院した．虫垂腺腫による虫垂重積症の報告は稀であり，その腹腔鏡下での切除例を経験したので文献的考察を加えて報告する．

　A 55-year-old man visited our hospital because of a positive fecal occult blood test. Endoscopic examination showed a type Isp polypoid lesion in the ascending colon and the tumor at the top of the appendix had invaginated into the ceacum completely. Abdominal CT showed an enhanced mass in the ascending colon. Histopathological examination of a biopsy revealed adenoma. Complete intussusception of the appendix into the ceacum was diagnosed and ileoceacal resection with D2 dissection was performed. Postoperative course was uneventful and the patient was discharged on operative day 8. We report this rare case with literature reviews.