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◆要旨:患者は70歳,男性.2007年12月に左下腹部痛を主訴として当院救急外来を受診した.S状結腸捻転の診断にて内視鏡的整復を行った際,腸管囊腫様気腫症(pneumatosis cystoides intestinalis;以下,PCI)を指摘された.その後外来で経過観察されていたが,S状結腸捻転を繰り返したため,高圧酸素療法による保存的加療を行った.しかしPCIは改善せず,S状結腸捻転も繰り返したため,腹腔鏡補助下S状結腸切除術を施行した.術後経過は良好で,現在再発は認めていない.保存的加療にても改善せず,S状結腸捻転を繰り返したPCIに対し,腹腔鏡下S状結腸切除術を施行した1例を経験したので報告する.
We report a patient with sigmoid volvulus associated with pneumatosis cystoides intestinalis (PCI) who was not treated with conservative therapy. A 70-year-old male was admitted for left lower abdominal pain in December 2007. He underwent successful endoscopic decompression for sigmoid volvulus. Pneumatosis cystoides intestinalis (PCI) was detected at this point. In October 2008, December 2008 and March 2009, the patient required repeated endscopic decompression for sigmoid volvulus. Hyperbaric oxygen therapy was performed but there was no improvement in PCI. In April 2009, he, again, experienced sigmoid volvus. We then decided to perform laparoscopy-assisted sigmoidectomy in May 2009. Postoperative course was uneventful and there has been no reccurence of PCI and volvulus.
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