{"title":"A Case of Jejunal Diverticulum Perforation One Month after Surgery for Strangulated Bowel Obstruction","authors":"Kohei OKAMOTO, Takatsugu MATSUMOTO, Takanori NISHIMURA, Yusuke SUKA, Motoki NAGAI, Yukihiro NOMURA, Masaki OGAWA, Yoshio SUZUKI","doi":"10.3919/jjsa.84.584","DOIUrl":null,"url":null,"abstract":"小腸憩室は稀な疾患であり,憩室穿孔の報告例は少ない.今回,絞扼性腸閉塞手術時に認めた空腸憩室が術後早期に発症した癒着性腸閉塞により穿孔に至った1例を経験したので報告する.症例は81歳の男性で,絞扼性腸閉塞にて当院へ紹介.同日緊急手術を施行したところ,小腸間膜根部が内ヘルニアにより絞扼されており,全小腸が虚血に陥っていた.また,虚血小腸に憩室を複数認めた.絞扼解除のみ施行し,第17病日に軽快退院となった.第38病日に癒着性腸閉塞を発症し,保存加療抵抗性であったため第44病日に癒着解除術を施行した.初回手術時に認めた小腸憩室のうち,1つが穿孔し腹腔内膿瘍を認めた.穿孔部を含めた小範囲の空腸を切除し,第59病日に退院となった.病理所見は仮性憩室であった.空腸仮性憩室が虚血の影響で脆弱化し,癒着性腸閉塞による腸管内圧上昇のために穿孔したと推察された.","PeriodicalId":19305,"journal":{"name":"Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)","volume":"127 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nihon Rinsho Geka Gakkai Zasshi (journal of Japan Surgical Association)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3919/jjsa.84.584","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}