THREE CASES OF TORSION OF THE GREATER OMENTUM TREATED WITH CONSERVATIVE THERAPY

大網捻転は比較的まれな疾患であり，これまでは術前診断が困難でほぼ全例が切除手術による治療を行われてきた．われわれはCTで確定診断を行い保存的治療を行った3例を経験したので報告する．41歳の男性で右側腹部痛を主訴に受診し，圧痛と反跳痛を同部位に認めた．発熱と血液検査で炎症反応の上昇を認め，腹部CTで一部層状の構造を伴う脂肪織濃度の腫瘤を認めた．大網捻転症と診断し絶食，抗生剤，輸液による保存的治療を行い，翌日には解熱し腹痛軽減の傾向がみられ以後も軽快した．同様に他の44歳と30歳の成人で保存的治療を行い軽快した．大網捻転は診断がつけば必ずしも手術が必用ではなく基礎疾患，年齢，症状の程度と経過，大網捻転症に関連する併存疾患を考慮した上で保存的に治療が可能である．

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