^<99m>Tc-O_4 シンチグラムが診断に有効であった大量下血を伴った回腸重複症の1例

概要

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A 7 year-old boy with a history of anemia was hospitalized because of massive gastrointestinal bleeding. Emergency laparotomy was performed under the presumptive diagnosis of Meckel's diverticulum, which was suggested by ^<99m>Tc scintigraphy. Microscopic examination confirmed the pathological diagnosis of ileal duplication with bleeding ulcer due to the ectopic gastric mucosa. The postoperative course was uneventful and the patient was discharged on the 14th postoperative day. Duplication of the alimentary tract is an unusual congenital anomaly that is often not suspected preoperatively. ^<99m>Tc scintigraphy was considered to be helpful in this case. It is important to differentiate alimentary tract duplication from Meckel's diverticulum because ^<99m>Tc scintigraphy could be positive for both of these cases. Alimentary tract duplication could be correctly diagnosed based on clinicopathological findings. The cases of alimentary duplication initially presented with gastrointestinal (G-I) bleeding were reviewed among the Japanese literature. The most frequent symptoms are abdominal pain, intussusception, and small bowel obstruction, but the massive gastrointestinal bleeding is thought to be rare in Japan.
日本小児外科学会の論文
1991-04-20