(346) 奈医誌.(]. Nara Med. Ass.) 46 , 1995 腸重積症で初発した S 状結腸癌の 2 例 新金岡豊川総合病院内科 松下和広,東野 正 奥田浩史,川本 博,畏斗秀興 新金岡豊川総合病院外科 白 山泰明,則武正三,豊川元邦 奈良県立医科大学第 3 内科学教室 岩井 均,池中康英,佐藤由美子,松為裕 諏訪好信,小泉雅紀,松村圭祐,松本 真 高谷 章,福井 博,辻井 正 T W OCASESOFSIGMOIDCANCERWITHINTUSSUSCEPTION KAZUHIRO MA TSUSHIT A , T ADASHIHIGASHINO , HIROSHIOKUDA , HIROSHIK A 羽 T AMOTOandHIDEOKINOSHI Dφα 'rtme' 叫t 01 Inte γ 叩 1 Medici: 叩 , Shi 的問削kaToyoka 相 aG 四 eγα1 Hostital YASUAKISHIRA YAMA , SEIZONORIT AKEandMOTOKUNITOYOKA WA Depart 問 ent01 s 附 1J e ァ y , ShinkanaokaToyoka 加 。 GeneralHo ψ ital HITOSHIIW AI , YASUHIDEIKEN AKA , YUMIKOSA TO , YuJI MA TSUI , YOSHINOBUSUW A , MASAKIKOIZUMI , KEISUKE MA TSUMURA , MAKOTO MA TSUMOTO , AKIRAT AKA Y A , HIROSHIFUKUIandTADASUTSU]II The Thi γ d Department 01 Inte γηα1 Medici 抗e , Nara Medic α 1 U 叫i 加問ity Receiv 巴 dSeptember8 , 1995 Abstract: Two-thirdsofadultpatientswithintussusceptionarereportedtohave enterointestinaltumors. We experienced two cases of sigmoid colon cance r. Two female patients , aged 54 and 32 , presented with severelowerabdominalpainand melena. Therectalexaminationrevealedthepresenceofahen-egg-sizedtumorwithbloody discharge in both patients. To determine the cause of persistent lower abdominal pain , we performed computed tomography(CT)scans , which showed sigmoid-rectal intussusception. Bariumstudiesandcolonoscopydisclosedthatintussusceptionwascausedbysigmoid cancerofBorrmanntype 1. ThesecasessuggestthatCTscanmaybeusefulforrapid diagnosis of sigmoid-rectal intussusception due to tumors in patients presenting with severe lowerabdomiminalpain.
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(346) 奈医誌. (]. Nara Med. Ass.) 46, 346~351 , 1995
腸重積症で初発した S状結腸癌の 2例
新金岡豊川総合病院内科
松下和広,東野 正
奥田浩史,川本 博,畏斗秀興
新金岡豊川総合病院外科
白 山泰明,則武正三,豊川元邦
奈良県立医科大学第 3内科学教室
岩井 均 , 池 中 康 英 ,佐藤由美子,松為裕
諏訪 好信,小泉雅紀,松村圭祐,松本 真
高谷 章,福井 博,辻井 正
TWO CASES OF SIGMOID CANCER WITH INTUSSUSCEPTION
KAZUHIRO MA TSUSHIT A, T ADASHI HIGASHINO, HIROSHI OKUDA,
YASUAKI SHIRA YAMA, SEIZO NORIT AKE and MOTOKUNI TOYOKA WA Depart問 ent01 s附 1Jeァy,Shinkanaoka Toyoka加。 GeneralHoψital
HITOSHI IW AI, YASUHIDE IKEN AKA, YUMIKO SA TO, YuJI MA TSUI, YOSHINOBU SUW A,
MASAKI KOIZUMI, KEISUKE MA TSUMURA, MAKOTO M A TSUMOTO, AKIRA T AKA Y A,
HIROSHI FUKUI and TADASU TSU]II
The Thiγd Department 01 Inteγηα1 Medici抗e,Nara Medicα1 U叫i加問ity
Receiv巴dSeptember 8, 1995
Abstract: Two-thirds of adult patients with intussusception are reported to have
enterointestinal tumors.
We experienced two cases of sigmoid colon cancer. Two female patients, aged 54 and 32,
presented with severe lower abdominal pain and melena.
The rectal examination revealed the presence of a hen-egg-sized tumor with bloody
discharge in both patients. To determine the cause of persistent lower abdominal pain, we
performed computed tomography(CT) scans, which showed sigmoid-rectal intussusception.
Barium studies and colonoscopy disclosed that intussusception was caused by sigmoid
cancer of Borrmann type 1. These cases suggest that CT scan may be useful for rapid
diagnosis of sigmoid-rectal intussusception due to tumors in patients presenting with severe
lower abdomiminal pain.
腸重積症で初発したS状結腸癌の 2例 (347)
Index Terms
intussusception, sigmoid colon cancer
る.はじめに
成人の腸重積症の約3分の 2は腫療性疾患によると報
告されている.また, S状結腸・直腸型の腸重積症は比較
的少なく,成人の腸重積症の約 2%程度と報告されてい
今回,われわれはS状結腸・直腸型の腸重積症で初発
した, Borrmann 1型の S状結腸癌を 2例経験したので
報告する.
Fig. 1. Case 1. Upright (Left) and supin巴 (Right)abdominal roent-genograms The colon was extrem巴lyexpand巴dby the bow巴1gas from th巴transverse colon to th巴 descendingcolon.