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概要 |
消化性胃十二腸潰瘍は,現在ではほぼ薬物療法で完治する.しかし,頻度的は低いが,手術が必要となる例もある.今回,われわれは,消化性胃十二指腸潰瘍による幽門狭窄症の経過観察中に偶然診断され,手術を施行した早期胃癌を経験したので,若干の考察とともに報告する. A 65-year-old man was admitted to our hospital with nausea, vomiting and a...ppetite loss. First upper endoscopic examination and X-ray examination showed a peptic ulcer and a pyloric stenosis. Fiberscope could not go through the pyloric ring. Computed tomography examination and biopsy showed no evidence of malignancy. Though we considered surgical resection of the stenosis at first, he could eat a staple food with therapy of proton pump inhibitor. So we followed up with upper endoscopic examinations. Second, third and forth upper endoscopic examinations showed no evidence of malignancy. Fifth upper endoscopic examination showed an ulcer scar on the pyloric ring and a 0-IIc carcinoma in the antral greater curvature. Distal gastrectomy with D2 lymph node dissection and B-II reconstruction. Pathologically, a mucosal carcinoma with no lymph node metastasis and Ul-III peptic ulcer were diagnosed.続きを見る
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