腹腔鏡下虫垂切除術が有用であった虫垂出血の1例—報告34例の集計

Laparoscopic appendectomy for appendiceal hemorrhage : A case report with literature review

◆要旨：下部消化管出血において，虫垂が出血源となることはきわめて稀である．今回筆者らは，虫垂出血例に対し腹腔鏡下虫垂切除術が有用であった症例を経験したので報告する．症例は33歳，男性．下血を主訴に当院消化器内科を受診した．下部消化管内視鏡検査で，虫垂開口部からの湧出性出血を認め，腹腔鏡下虫垂切除術を施行した．消化管出血に対する止血治療は，内視鏡的止血，IVRなど非侵襲的治療が第一選択とされることが多いが，虫垂出血においては原因の特定・患者QOLを考慮すると，腹腔鏡下虫垂切除術は治療・原因究明の両者に有用であり，結果的には低侵襲治療になりえるものと思われた．

Although lower intestinal bleeding is relatively common, bleeding from the appendix is extremely rare and only 34 cases have been reported in the literature. We report a case of appendiceal hemorrhage that was successfully treated by laparoscopic surgery. Case : A 33-year-old man complained of several episodes of rectal bleeding. Colonoscopy revealed gushing bleeding from the appendix and the patient underwent emergency laparoscopic appendectomy. Noninvasive treatment such as endoscopy or IVR is often recommended as the treatment for gastrointestinal bleeding. For appendiceal hemorrhage, laparoscopic appendectomy is useful for both its diagnosis and treatment, leading to better quality of life for the patient.