二期的手術により広範囲腸切除を避け得た Shonlein-Henoch 紫斑病出血性腸壊死の 1 例

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Hemorrhagic necrosis and perforation of the intestine in patients with SHP has recently attracted attention as a surgical emergency. This is a case report of a 6 year 4 month-old girl who had three sections of hemorrhagic necrosis of the ileum at the first laparotomy, each of them was more than 10cm in length. The patient underwent peritoneal drainage and an appendectomy, because it was difficult to determine the viability of the subserosal hemorrhagic wall of the intestine. Fecal discharge from the drains prompted us to perform a reoperation 11 days after the initial operation. Subserosal hemorrhage had disappeared completely by the time of re-laparotomy, and only 10cm of stenotic and perforated intestine had to be resected without a massive intestinal resection. The authors recommend simple drainage and a staged operation for hemorrhagic necrosis in patients with HSP in order to avoid the risk of anastomotic leakage and massive resection of the intestine.
特定非営利活動法人日本小児外科学会の論文
1990-12-20