腹腔鏡下にて修復しえた横行結腸に発症した特発性成人腸重積症の1例

An adult case of idiopathic intussusception treated by laparoscopy reduction : A case report

◆要旨：患者は50代，女性．3日間続く腹痛を主訴に来院した．腹部CTにて左上腹部にtarget signを認め，jejunojejunal typeの腸重積症と診断し腹腔鏡下手術を施行した．全小腸を観察したが重積腸管を認めず，横行結腸に大網を一部巻き込む形の重積部位を確認し，これをHutchinson手技にて解除した．腫瘍性病変の有無などが診断されていないため解除のみで手術を終了した．術後大腸内視鏡を施行したが明らかな腫瘍性病変は認めず，特発性腸重積症の診断となった．成人の腸重積症の発生原因の多くは腸管の腫瘤性病変であり，特発性腸重積症は稀である．今回，横行結腸に発症した成人特発性腸重積症の1例を経験したので報告する．

A 50th years-old women visited our hospital complaining of left upper abdominal pain. Abdominal contrast-enhanced computed tomography revealed intussusception of jejunum. Emergency surgery was performed laparoscopically. The entire jejunum was intact and invagination was observed in the transverse colon. Hutchinson procedure was used laparoscopically. Since intraoperative palpation showed no concrete evidence of tumor, no additional procedure was performed. After the operation, colonoscopy was performed but no cause of intussusception was found. One year after the operation, there has been no recurrence of intussusception. If intraoperative finding shows no evidence of tumor or specific disease, laparoscopic surgery is a good and less invasive procedure.