アブストラクト
Japanese
| Title | 腹部リンパ管奇形 (リンパ管腫) 28例の検討と感染・炎症例へのドレナージの有効性 |
|---|---|
| Subtitle | 原著 |
| Authors | 臼井秀仁1,2, 新開真人1, 北河徳彦1, 望月響子1, 八木勇磨1, 奥村一慶1, 川見明央1, 大関圭祐1 |
| Authors (kana) | |
| Organization | 1神奈川県立こども医療センター外科, 2横浜市立大学外科治療学 |
| Journal | 日本小児外科学会雑誌 |
| Volume | 58 |
| Number | 7 |
| Page | 966-971 |
| Year/Month | 2022 / 12 |
| Article | 原著 |
| Publisher | 日本小児外科学会 |
| Abstract | 「要旨」【目的】腹部リンパ管奇形 (lymphatic malformation, 以下LM) は腹部リンパ管腫とも呼ばれる稀な疾患で, 急性腹症や腹部膨満を発症し, 緊急の診断・処置を迫られることがある. 一方で無症状のまま発見される場合もあり, 本疾患の適切な治療方針は確立されていない. 当院での経験を検討し, 特に感染・炎症例へのドレナージの有効性を報告する. 【方法】1997〜2016年の20年間に当院で腹部リンパ管腫 (腹腔内, 後腹膜) の病名で加療した患者28例を対象とした. 診療録を後方視的に検討した. 【結果】診断時年齢は中央値で3歳であった. 有症状例は24例で, 発症機転は感染・炎症10例, 嚢胞内出血4例, 非感染非出血腫大2例, 捻転2例, その他6例であった. 有症状24例に対し介入を行った. 感染・炎症を除く14例中13例 (92.9%) で摘除術を施行した. 感染・炎症の10例は, 1例に緊急摘除を行ったが, 9例で抗生剤単独あるいはドレナージを加えることで感染は沈静化した. その後, 1例がイレウスを合併し手術を要したが, 8例は待機的アプローチを選択でき, 硬化療法1例, 摘除2例を行い, 他の5例では介入を要さず退縮した. その後の再燃は認めていない. 【結論】有症状の腹部LMは摘除の適応であるが, 感染・炎症例では抗生剤単独あるいはドレナージを加えることにより外科摘除なしで退縮へと繋げる待機的アプローチも選択肢のひとつとなりうると考えられた. |
| Practice | 臨床医学：外科系 |
| Keywords | リンパ管奇形, リンパ管腫, ドレナージ, 退縮, lymphangioma, lymphatic malformation, drainage, regression |
English
| Title | Experience of 28 Cases of Abdominal Lymphangioma (Lymphatic Malformation) and Effectiveness of Drainage in Cases of Infection and Inflammation |
|---|---|
| Subtitle | Original |
| Authors | Hidehito Usui1,2, Masato Shinkai1, Norihiko Kitagawa1, Kyoko Mochizuki1, Yuuma Yagi1, Kazuyoshi Okumura1, Akio Kawami1, Keisuke Ozeki1 |
| Authors (kana) | |
| Organization | 1Department of Surgery, Kanagawa Children's Medical Center, 2Department of Surgery, Yokohama City University |
| Journal | Journal of the Japanese Society of Pediatric Surgeons |
| Volume | 58 |
| Number | 7 |
| Page | 966-971 |
| Year/Month | 2022 / 12 |
| Article | Original article |
| Publisher | Japanese Society of Pediatric Surgeons |
| Abstract | Abdominal lymphatic malformation (LM) is a rare disease that can cause acute abdomen and abdominal distention requiring urgent diagnosis and treatment. It may also be detected incidentally. Appropriate treatment strategies for this disease have not been established. Here, we present our experience and report on the effectiveness of drainage in cases of LM with infection and inflammation. The medical records of 28 patients treated for LM (intraperitoneal or retroperitoneal) between 1997 and 2016 were retrospectively reviewed. The median age at diagnosis was three years. There were 24 symptomatic patients, including 10 with infection/inflammation, four with intracystic hemorrhage, two with non-infectious non-hemorrhagic enlargement, two with torsion, and six with other conditions. Intervention was performed in all symptomatic patients. Surgical resection was performed in 13 of 14 (92.9%) patients without infection and inflammation. In the 10 patients with infection and inflammation, antibiotic treatment with or without drainage successfully controlled infection in nine, whereas one required emergency resection after antibiotics. Of these nine patients, one underwent surgery for subsequent ileus, one underwent sclerotherapy, and seven were followed up as outpatients ; two required surgery and regression occurred in five patients. No recurrences were observed. Symptomatic abdominal LM is an indication for surgical resection ; however, in patients with infection and inflammation, antibiotic therapy with or without drainage may be an option to control the symptom, leading to subsequent regression. |
| Practice | Clinical surgery |
| Keywords | lymphangioma, lymphatic malformation, drainage, regression |
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残りの11件を表示する
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