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ID 32893
JaLCDOI
フルテキストURL
著者
Ashizawa, Tatsuto Hachioji Medical Center of Tokyo Medical University
Hama, Koichiro Hachioji Medical Center of Tokyo Medical University
Tanaka, Hiroaki Tokyo Metropolitan Toshima General Hospital
Ando, Masayuki Tokyo Metropolitan Toshima General Hospital
抄録
A 64-year-old woman was admitted to our hospital with lower abdominal pain. Routine laboratory values were unremarkable except for the white blood cell count (15,000/micro litter) and the C-reactive protein (CRP) value (22.5 mg/dl). A Computed tomography (CT) scan revealed air collection in the middle of the anterior pararenal space. One day later, CT revealed air collection in the anterior pararenal space spread to the right side and abscess in the sigmoid mesentery. Because an intramesocolic perforation of the sigmoid colon was suspected, an emergency operation was performed. Abscess formation was recognized in the sigmoid mesentery, and sigmoidectomy including the contaminated mesentery and Hartmann.s procedure were performed. The perforation was 3 cm in diameter, and some diverticula were present in the vicinity of the perforated site. The specimen microscopically revealed perforation at the edge of the diverticulum in association with sudden disruption of the proper muscle layer. Based on pathological findings, intramesocolic diverticular perforation of the sigmoid colon was diagnosed. The present case is a very rare condition. However, it was possible to make a diagnosis preoperatively by detecting air collection in the anterior pararenal space on CT scan. If a sigmoid perforation occurs between the leaves of the mesocolon, air extends into the root of the sigmoid mesocolon and within the anterior pararenal space.
キーワード
colon diverticulosis
intramesocolic perforation
computed tomography
free air
Amo Type
Case Report
発行日
2007-10
出版物タイトル
Acta Medica Okayama
61巻
5号
出版者
Okayama University Medical School
開始ページ
299
終了ページ
303
ISSN
0386-300X
NCID
AA00508441
資料タイプ
学術雑誌論文
言語
English
論文のバージョン
publisher
査読
有り
PubMed ID
Web of Sience KeyUT