小児開腹術後腸重積症の2例 : 本邦報告59例についての検討

概要

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We have experienced two cases of postoperative intussusception (POl) in childhood during the past 25 years at our institution. POI occured following extirpation of neuroblastoma originated from It. advenal gland, and resection of the incarcerated jejunum for congenital mesenteric hernia. The site of intussusception was ileo-ileadl type both cases, and they were successfully reduced by Hutchinson's method During the same period, 1040 cases underwent laparotomy at our institution. The frequency of POI was 0.19%, which was very rare. According to 59 cases of POI in Japan, common symptoms were abdominal distension, bile vomiting, and increasing nasogastric aspirate. Rectal bleeding and palpable mass were rare compared with those in idiopathic intusssusception. POI developed the symptoms within a week after initial surgery in 84.8% of patients, and bowel resection was required only in 10.3% POI occured following various kinds of laparotomies, but many cases of POI were reported at post-operative course of neuroblastoma. Generally, POI is a very rare complication and its accurate preoperative diagnosis is very difficult. POI shoud be suspected with signs of bowel obstruction in the early postoperative period and the prompt surgical management shoud be done to prevent bowel resection.
特定非営利活動法人日本小児外科学会の論文
1992-10-20