上部消化管造影検査後に発症した結腸穿孔によるバリウム腹膜炎に対して腹腔鏡下手術を施行した2例

Two cases of laparoscopic surgery for sigmoid colon perforation after gastrography

◆要旨：症例1は67歳，女性．上部消化管造影検査3日後に腹痛を認め，その翌日に当院を受診した．腹部CTでS状結腸穿孔と診断し，同日腹腔鏡下手術を施行した．S状結腸に5mmの穿孔部を認め，穿孔部のS状結腸で双孔式人工肛門を造設した．症例2は75歳，女性．上部消化管造影検査2日後に下腹部痛を認め，当院を受診した．腹部CTで結腸穿孔と診断し，同日腹腔鏡下手術を施行した．S状結腸に3cmの穿孔部を認め，穿孔部を切除しHartmann手術を施行した．上部消化管造影検査後の大腸穿孔は重篤な合併症である．今回，上部消化管造影検査後に発症した結腸穿孔に対して腹腔鏡下手術を施行した2例を経験したので報告する．

Case 1 was a 67-year-old woman who visited our hospital because of abdominal pain. She had undergone a gastrography 4 days earlier. An abdominal CT scans revealed sigmoid colon perforation. At emergency laparoscopic surgery, perforated sigmoid colon was observed, and we performed double barreled colostomy. Case 2 was a 75-year-old woman who presented to our hospital because of lower abdominal pain. She had undergone a gastrography 2 days earlier. An abdominal CT scans revealed colon perforation. At emergency laparoscopic surgery, perforated sigmoid colon was noted, and we performed Hartmann's procedure. Colon perforation after gastrography is a severe complication. We report two cases of laparoscopic surgery for sigmoid colon perforation after gastrogaphy with literature review.