回腸異所性胃粘膜が原因となった腸重積症の1例

概要

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A 2-year-old boy had been experiencing repeated episodes of intussusception for five month. In one of these attacks, the exploratory laparotomy was performed. The mass was not palpable at the leading point of the intussusception. On December 19, 1984, he was readmitted to our university hospital with abdominal pain and vomiting. A barium enema examination revealed an intussusception in the splenic flexure, but hydrostatic reduction was imcomplete. The emergency laparotomy was performed. The intussucception was reduced with Hutchinson's method. About 30cm proximal to the ileocecal valve at the antimesenteric side, a mass, measuring 2.5 by 2.0 by 2.0cm, was found. Consequently a llcm segment of ileum resected and end-to-end anastomosis was made. Microscopic examination revealed gastric mucosa including chief and parietal cells with rugose type. The patient was discharged on the seventeenth day after operation without any significant complication. Heterotopic gastric mucoca in the small bowel, other than in the Meckel's diverticulum or other congenital anomalies, is exceedingly rare. To our knowledge, sixteen such cases in children have been reported in English and Japanese literature. The recurrent intussusception would be worth while searching such local causes including heterotopic gastric mucosa.
日本小児外科学会の論文
1987-08-20