内容紹介
Summary
A 63-year-old man had abdominal pain and sequential constipation and diarrhea. He complained of abdominal pain and vomiting, and was admitted to the hospital with a diagnosis of ileus. CT demonstrated a colonic obstruction at the splenic flexure, which was suspected to be colon cancer. Ileostomy was performed in March 2015, and he underwent radical resection in May 2015. Cancer of the pancreas tail had invaded the spleen, colon, stomach, and left renal capsule. Distal pancreatectomy was performed, along with extended right hemicolectomy, left nephrectomy, partial gastrectomy, and stoma closure. He received adjuvant chemotherapy for 6 months after the operation. He is alive without recurrence of pancreatic cancer for over 3 years.
要旨
膵尾部癌は一般に症状の発現が遅いため,しばしば高度進行癌として発見されるが,結腸浸潤による腸閉塞を初発症状として発見された膵尾部癌の報告は比較的まれである。今回われわれは,結腸脾弯曲部への直接浸潤により腸閉塞,穿孔性腹膜炎のため当院に救急搬送され,二期的に根治切除術を施行した後,術後補助化学療法を行い3年以上無再発生存中の1例を経験した。腸閉塞を伴う膵尾部癌は予後不良であり,長期生存の報告はまれである。文献的考察を加えて報告する。
目次
A 63-year-old man had abdominal pain and sequential constipation and diarrhea. He complained of abdominal pain and vomiting, and was admitted to the hospital with a diagnosis of ileus. CT demonstrated a colonic obstruction at the splenic flexure, which was suspected to be colon cancer. Ileostomy was performed in March 2015, and he underwent radical resection in May 2015. Cancer of the pancreas tail had invaded the spleen, colon, stomach, and left renal capsule. Distal pancreatectomy was performed, along with extended right hemicolectomy, left nephrectomy, partial gastrectomy, and stoma closure. He received adjuvant chemotherapy for 6 months after the operation. He is alive without recurrence of pancreatic cancer for over 3 years.
要旨
膵尾部癌は一般に症状の発現が遅いため,しばしば高度進行癌として発見されるが,結腸浸潤による腸閉塞を初発症状として発見された膵尾部癌の報告は比較的まれである。今回われわれは,結腸脾弯曲部への直接浸潤により腸閉塞,穿孔性腹膜炎のため当院に救急搬送され,二期的に根治切除術を施行した後,術後補助化学療法を行い3年以上無再発生存中の1例を経験した。腸閉塞を伴う膵尾部癌は予後不良であり,長期生存の報告はまれである。文献的考察を加えて報告する。