急性熱性皮膚粘膜リンパ節症候群(MCLS)によるイレウス例

概要

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A two year old girl with an intestinal obstruction due to mucocutaneous lymphnode syndromd (MCLS) was admitted to our hospital with vomiting, abdominal distension and MCLS. MCLS was diagnosed by typical skin eruptions, lymphnode swelling and fever. Intestinal obstruction was diagnosed by barium enema as a mechanical obstruction which would require surgery. The operative finding showed the intestinal obstruction was caused by a kinked adhesion between the inflamed lymphnode and jejunum. Intestinal decompression and adhesiolysis were done. In post-operative course, obstruction recurred 8 days after the. surgery. In spite of medical treatment, the intestinal obstruction was not released. Twelve days after the previous operation, a second laparotomy was done. Severe adhesion was found in the abdominal organ. After adhesiolysis of the entire intestine, an internal intestinal splint catheter was inserted through gastrostomy into the intestine and the colon. Although posjt-operative intestinal paralysis was severe, the patients course was uneventfull. Only 5 cases of intestinal obstruction due to MCLS has been reported in literature. All these cases had weak intestinal peristalsis. This paralytic intestinal obstruction is a typical sign of MCLS ileus.
特定非営利活動法人日本小児外科学会の論文
1982-06-20