腹腔鏡補助下に切除した広範大腸静脈型血管腫の1例

A case of diffuse venous hemangioma resected under laparoscopic assisted surgery

◆要旨：患者は82歳，男性．下血，倦怠感を主訴に受診した．下部消化管内視鏡検査で，横行結腸脾彎曲部からS状結腸にかけて多発血管腫を認めた．貧血は血管腫からの出血が原因と考えられたため，腹腔鏡補助下結腸左半切除術を施行した．血管腫は，左側結腸の粘膜面，漿膜面だけでなく腸間膜や腹膜にも広範囲に存在していたが，腹腔鏡にて全体を観察し，ベッセルシーリングデバイスを使用することにより安全に切除可能であった．大腸血管腫は稀で，特に静脈型血管腫の報告例は非常に少ない．今回，広範な大腸静脈型血管腫の1切除例を経験したので，若干の文献的考察を含めて報告する．

A 82-year-old man was admitted to our hospital because of melena and malaise. Colonoscopy revealed diffuse hemangioma of the left colon, which caused melena without active bleeding. Laparoscopy-assisted left hemicolectomy was performed electively. Although the hemangioma was widely distributed not only in the mucosa and on the serosa of the left colon but also the mesentery and peritoneum, we were able to safely resect it using a vessel sealing device, under the view of the laparoscopy. Hemangioma of the colon is rare, especially venous hemangioma. In this paper, a case of diffuse venous hemangioma resected is presented. We also briefly review the literature on the disease.