A CASE OF PIMELITIS OF THE MESENTERY, GREATER OMENTUM AND RETROPERITONEUM CAUSING INTESTINAL OBSTRUCTION

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A 72-year-old man who underwent lymph node dissection for paraaortic lymph node metastasis after operation for left renal cancer on June 17 2002 had abdominal pain on the 13th hospital day and was diagnosed as having intesinal obstruction by abdominal x-ray examination. Since niveau formation of the large intestine was noted, colonofiberscopy was conducted which showed a narrowing portion at the descending colon. No abnormalities were identified on the mucosa. Abdominal CT scan revealed fluffing of fatty tissue in the vicinity of the descending colon, but no tumor was identified. Laparotomy was performed on July 18. Upon laparotomy we saw the hypertrophied and indurated omentum and mesentery in the vicinity of the descening colon, at where the descending colon narrowed. Pimelitis of the mesentery, omentum and retroperitoneum surrounding the intestine was diagnosed. A part of the greater omentum was excised and side-to-side anastomosis between the transverse and descending colon was made. Histopathological study showed findings of pimelitis. The patient's postoperative course was uneventful.We present this case of pimelitis with intestinal obstruction after abdominal operation, together with a review of the literature.
日本臨床外科学会の論文