進行性顏面壞疽剖檢例

　緒言

　鼻腔及び其周囲組織から発生する進行性壞疽性炎症で其本態が未だ全く不明であり，明らかに水癌と区別し得る疾患に就ては1917年S. Kaufmannの報告以來Henning u. Wirth（1926），Kraus（1929），Steward（1933），Voss（1934），Strum（1935），Bayer（1936），Joister（1936），Knopp（1939），Moritz（1939），Lüdtke，Schütz，Cuix，Georg. 等が報告し，本那に於ては今井，川名，金原，水野，松浦，俣野，柴田，北川，田中，森本，遠山，山崎，藏本，小山，藤田，恒松，浅野，林，廣田，岡野，西山，立木，宮原，片山，吉田，近くは磯野，本間，福武，土佐，林等30名にも及ぶ報告がある．吾が臨床に於ても亦最近本症の1例を経驗した．昭和7年当教室水野の報告した治験例と異なり種々の治療の甲斐なく遂に死の轉帰をとつたが，幸に病理解剖に附するを得たので茲に報告し諸賢の御批判を仰ぎ度いと思う．

　Kano reports on a case of progressive gangrene of face. The patientF, a man 34 years of age, was affected with a lesion which, in the beginning, was a small ulcer below the right eye. Since 5 months ago from the time of examination this lesion began to increase in size and spread over the nasal root areas. At first the newly involved parts were only edematous but soon they were included to become integral part of the ulcer and, now, measured 7.5Х4 cm in dimensions. With fistulous opening leading away from the ulcer, the nasal cavity and the oral cavity through the hard palate are found to be in a direct communication with each other. The lips of this ulcer are characterized by induration and being raised on the external surface while, the inner is excavated and almost devoid of granulation tissues ; the contents are dirty yellowish green accumulation of malodorous products of gangrene. No specific type of bacteria is recorvered by culture or animal experimentation. For treatment drastic cauterization was used which reached out well into surrounding normal tissues and injections of penicillin in large amounts. There were signs of temporary remission in the progressive pathological process but, the patient finally died of uncontrolable hemorrhage on his 76th day of hospitalization and the 7th month of his illness.