直腸・S状結腸びまん性海綿状血管腫の1例

Diffuse Cavernous Hemangioma of the Rectosigmoid Colon, Report of a Case

要旨　患者は46歳女性，26年来の下血と，貧血，腹痛を主訴とし来院．腹部単純X線所見で直腸S状結腸の走行に一致する多数の大小不同の石灰化像が見られた．大腸造影X線検査で直腸内腔の著明な狭小化，拇指圧痕様の壁不整が見られた．大腸内視鏡検査で肛門皮膚からS状結腸約40cmに及ぶ直腸S状結腸のびまん性海綿状血管腫と診断．Miles手術を行った．

　A 46-year-old woman was admitted to our hospital with a history of intermittent rectal bleeding of 26 years' duration. Plain roentogenogram of the abdomen showed numerous phleboliths (Fig 1). Contrast radiographic examination of the rectosigmoid colon was remarkable for the rectal deformity with multiple thumbprinting like compression (Fig. 2). Endoscopic examination revealed plum-colored submucosal nodules of the rectum and thickened haustral fold of the sigmoid colon (Fig. 4). These findings led to the diagnosis of diffuse cavernous hemangioma of the rectosigmoid colon. Miles' operation was performed. Resected specimen was shown to have the cavernous hemangioma of 40 cm long (Fig. 5). The patient also had cavernous hemangiomas in both the vaginal wall and lower portion of the uterus.