腹腔鏡補助下手術が診断に有用であった食餌性イレウスの2例

Successful Diagnosis and Treatment for Food-induced Bowel Obstruction by Laparoscopic Procedure: Report of Two Cases

　症例1は52歳，男性．イレウスの診断で入院した．CT検査で回腸に腫瘤影がみられ，腹腔鏡補助下手術を施行した．終末回腸から40cm口側の回腸に腫瘤を認め，小開腹下に腫瘤摘出を行った．腫瘤は植物繊維の残渣であった．症例2は13歳，女性．腹部打撲後の腹痛で紹介され，腹腔鏡補助下手術を施行した．終末回腸から50cm口側の回腸にメッケル憩室を認め，小開腹下に憩室根部を切開すると，その内腔は糸こんにゃくで充満しており，摘出・憩室切除術を行った．開腹歴のないイレウス，急性腹症に関しては食事内容を聴取し，食餌性イレウスも念頭におくべきである．腹腔鏡補助下手術は，確定診断，病変部位の特定にきわめて有用であった．

We report two cases of food-induced bowel obstruction without past history of open laparotomy, that were successfully diagnosed and treated by laparoscopic procedure. Case 1, A 52-year-old man was admitted to the hospital with a diagnosis of bowel obstruction. CT examination revealed a ileal mass. Laparoscopic assisted sur-gery was performed. A solid mass in the ileum was found, 40 cm proximal from the terminal ileum. The mass, which was made from vegetable fiber was removed by mini-laparotomy.