慢性腹痛の原因と考えられた移動性盲腸に対し腹腔鏡下盲腸固定術が有用であった1例

Usefulness of laparoscopic cecopexy for mobile cecum, suspected cause of chronic abdominal pain

◆要旨：慢性腹痛の原因と考えられた移動性盲腸に対して腹腔鏡下盲腸固定術を行い良好な結果を得たので，報告する．患者は26歳，女性．右下腹部痛を主訴に受診したが，CT検査，上部内視鏡検査，大腸内視鏡検査では特に異常を認めなかった．小腸造影で移動性盲腸と診断され，腹痛の原因である可能性が高いと考えられた．その後も症状が持続，増悪したため，インフォームドコンセントのうえで腹腔鏡下盲腸固定術を施行したところ，腹痛は消失しQOLも改善した．移動性盲腸で自験例のように腹痛を伴い，内科的治療が困難な場合には腹腔鏡下盲腸固定術は低侵襲かつ有効な術式と思われた．

　We report a patient with chronic abdominal pain, most likely caused by mobile cecum, who underwent laparoscopic cecopexy. A 26-years-old female complained of right lower abdominal pain, but computed tomo-graphy, upper gastrointestinal endoscopy, colonoscopy　could not detect any signs of disease. Small bowel series detected mobile cecum, which was considered to be the cause of abdominal pain. The pain continued and worsened after the diagnosis, so laparo-scopic cecopexy was performed with the informed consent from the patient. The symptom vanished and the patient's QOL improved after the surgery. Laparoscopic cecopexy is less invasive surgery and useful method for the treatment of mobile cecum causing abdominal pain which is resistant to medication.