腸重積で発見された小腸悪性リンパ腫の1切除例

概要

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A 16-year-old male was admitted to our hospital for abdominal pain and nausea. A plain abdominal X-ray showed inflated loops of small intestine but no signs of ileus and an ultrasound examination of the abdomen showed no abnormal findings. The patient was treated with parenteral nutrition and antibiotics, but the symptoms did not resolve, and on hospital day 5th he sudden experienced the onset of severe abdominal pain. Since a scout film of the abdomen showed multiple air-fluid levels, we inserted a long intestinal tube, but the symptoms failed to resolve in response to decompression of the bowel. Small intestinal radiography revealed intussusception of the small intestine, and a segmental resection of the ileum was performed on hospital day 6th. Macroscopically, a 38 × 28 mm well-defined tumor with irregular depression was detected in the resected ileum, which included necrotic intestine. Histopathologic examination of the tumor in the surgical specimen led to a diagnosis of non-Hodgkin' s lymphoma (Burkitt type), and no lymph node involvement was found. The patient had an uneventful postoperative course, and after one course of CHOP therapy was discharged on postoperative day 27th.
東京女子医科大学の論文
2003-10-25