Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
症例
腸重積を伴う小腸inflammatory fibroid polypを単孔式腹腔鏡下術で切除した1例
高林 一浩斉田 芳久榎本 俊行大辻 絢子中村 陽一長尾 さやか渡辺 良平長尾 二朗草地 信也高橋 啓
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2013 年 82 巻 1 号 p. 162-163

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Small bowel inflammatory fibroid polyp (IFP) is an idiopathic inflammatory polyp, which usually presents as intussusception and ileus requiring emergency laparotomy. In this study, we report a case of IFP associated with intussusception treated by single port laparoscopy. A woman in her 70’s was referred to our hospital due to ileus. Abdominal CT demonstrated a tumor at the terminal ileum. Initially an ileus tube was inserted to enable decompression. Colonoscopy of the ileum then identified the tumor at the distal end of the intussusception. Duly we elected to perform surgical intervention. In the first stage of surgery, a 3 cm umbilical incision was made and the abdomen insufflated. Using single port laparoscopy the site of intussusception was confirmed, and it was extracorporeally reduced by Hutchinson’s maneuver combined with partial small bowel resection. The patient’s prognosis was favorable and she was discharged on the fifth day postoperatively. Pathologically, the tumor was diagnosed as IFP based on the presence of granulation tissue by inflammatory cell infiltration and fibroblast growth. As the small intestine is not fixed usually, single port laparoscopy is considered to be both appropriate and achievable. Even in cases of ileus, use of laparoscopy is possible after the intestine is fully decompressed.
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© 2013 一般社団法人 日本消化器内視鏡学会 関東支部
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