空腸脂肪腫の1例

Submucosal Lipoma of the Jejunum, Report of a Case

要旨　消化管出血の原因となった陰茎亀頭状の空腸脂肪腫の1例を報告した．患者は64歳の男性，血便と貧血の原因検索のため上部・下部消化管内視鏡検査を施行したが，出血源となる病変は認めなかった．小腸造影検査では上部小腸から中部小腸移行部に亜有茎性の隆起性病変を認め，圧迫で形態が変化するため軟らかい粘膜下腫瘍である脂肪腫と診断した．同病変が消化管出血の原因と考え，外科的に腫瘍を摘出した，病理組織学的には異型のない脂肪細胞から成る脂肪腫で，頭頂部は炎症性変化が強く壊死に陥っていた．

　A case with a lipoma of the jejunum manifesting melena was reported. The tumor was a penis-like protrusion with a smooth surface measuring 50×24 mm and showing erosion. Histologically, it was a submucosal lipoma. Neither panendoscopy nor colonoscopy disclosed any abnormalities, but barium meal examination of the small intestine showed a tumor shadow. Compression study revealed that the tumor was soft and the surface of the lesion was smooth. We suspected that the tumor was a jejunal lipoma.

　For the diagnosis of small intestinal tumors, diagnosis is assisted greatly by double contrast study and compression study.