腹腔鏡補助下に切除し得た空腸動静脈奇形の1例

Jejunal Arteriovenous Malformation Treated by Coil Embolization and X-ray-guided Laparoscopic Surgery:Report of a Case

　症例は71歳，男性．肝硬変症（C型肝炎）にて加療中であった．1998年3月，多量の下血を認め，空腸動静脈奇形の診断で血管内マイクロコイル留置術にて止血が行われた．同年11月，再び大量の下血をきたし同部位からの出血と診断され再度マイクロコイル留置にて止血術を施行したのち，腹腔鏡下にX線透視を併用しつつ動静脈奇形の存在する空腸切除術を施行した．術前にマイクロコイル留置術が施行された小腸動静脈奇形に対してはX線透視併用腹腔鏡下小腸切除術は低侵襲で有効な手段である．

A 71-year -old man was admitted to our hospital because of severe tarry stools. A superior mesenteric angiogram revealed a jejunal arteriovenous malformation (AVM) and a microcoil embolization was perfomed. Eight months later, massive bleeding from AVM was observed and microcoils were placed again. Operation was performed laparoscopically using intraoperative fluoroscopy. Microcoils. placed in mesenteric vessels. were de-tected easily and laparoscopic assisted jejunal resection was performed. Postoperative course was uneventful and the patient was discharged from our hospital on the 9th hospital day.