Koichiro Nakano

A CASE OF GAS GANGRENE IN THE NECK

Gas gangrene in the neck region is very rare. A case of gas gangrene spreading in the neck is reported. A 59-year-old man having a history of diabetes mellitus and chronic hepatitis was admitted to our hospital because of pharyngalgia. He was treated with antibiotics. But he had severe swelling of the neck and a high fever after four days. By x-p and CT, some free air was found in the neck. He was diagnosed as having gas gangrene and had emergency complementary surgical drainage and debridement under general anesthesia. The postoperative course was good without any complications. To diagnose gas gangrene, CT is very valuable. Complementary surgical drainage and debridement are necessary for treatment of gas gangrene.

A Case of Peritonitis Chronica Fibrosa Incapsulata Presenting as lleus after Irradiation.

放射線照射後にイレウスにて発症した腸管膜様包衰症の1例を経験したので報告する.症例は, 子宮頸癌のため広範子宮全摘術と術後放射線照射を受けた既応を持つ62歳の女性で, 腹部膨満感, 嘔気を主訴に来院した.放射線障害による腸管癒着性イレウスの診断で腸切除術を施行した.終末回腸が厚さ約1mmの被膜に覆われた10.8×7.6×7.4cmの腫瘤を形成しており, 腸管膜様包裏症と診断した.腸管膜様包裏症は比較的まれな疾患で, 本邦では1970年以降現在までに本例を含め23例の報告があるのみで, 放射線照射に起因した本症の報告は本例が初めてである.また, 本症の術前診断は困難であるが, 本例では腹部CTがその特徴的な所見をとらえていた.