腹腔鏡下にて整復しえた先進部に腫瘍性病変を認めない胃十二指腸重積の1例

Laparoscopic resolution of a case of gastroduodenal intussusception without a tumorous lesion

◆要旨：先進部に腫瘍性病変を認めない非常に稀な胃十二指腸重積に対し腹腔鏡下にて整復しえた1例を経験した．患者は53歳，男性．アルコール性肝硬変の増悪にて当院入院中に心窩部の激痛，嘔吐が出現し，腹部造影CTにて胃壁全体の浮腫と，前庭部から幽門の十二指腸下行脚への嵌頓，重積像を認めた．以上の画像所見より胃十二指腸重積と診断した．肝硬変（Child C）の全身状態も考慮し腹腔鏡下にて整復し良好な経過を得た．胃十二指腸重積の報告例はすでに多くあるが，すべて開腹にて整復されており，腹腔鏡下で整復しえたのは自験例が初めてであった．

We report a case of gastroduodenal intussusception that was resolved laparoscopically. A 53-year-old man was admitted for treatment of alcoholic hepatocirrhosis. He developed sudden epigastric pain and vomiting. An abdominal computerized tomography scan indicated a thickened stomach wall and the presence of the pyloric antrum in the duodenal bulb. For this reason, we diagnosed the patient with gastroduodenal intussusception. Given his general condition, laparoscopy was performed to return the pyloric antrum into its appropriate position. His condition is reportedly well since the procedure. This is the first case of gastroduodenal intussusception that has been resolved using laparoscopy.