论文信息 - A CASE OF RECTAL CANCER MANIFESTED BY LIVER ABSCESS

A CASE OF RECTAL CANCER MANIFESTED BY LIVER ABSCESS

症例は57歳，男性．1カ月前に，全身の関節痛と下痢を主訴に近医受診し，通院加療で症状軽快した．2日前より38～40℃台の発熱みられ，血液検査上，高度の炎症反応を認めたため，当院を紹介された．腹部CT，超音波検査の結果，肝膿瘍の診断のもと緊急入院となった．入院後，メロペネムの投与を開始したが，解熱傾向が見られなかったため，経皮経肝膿瘍ドレナージ（PTAD）を施行した．黄色膿性液を吸引したが細菌検査，細胞診ともに陰性であった．PTAD施行翌日より38℃以下まで解熱傾向を示し，症状，炎症反応ともに改善したため，並行して肝膿瘍の原因検索を施行した．注腸検査で，Rb前壁に径4cm大の潰瘍性病変を認め，直腸癌の診断で，Miles手術を施行した．病理組織学的には，中分化型腺癌で，深達度は，Aで，リンパ節転移や腹膜播種，遠隔転移は見られず，StageIIであった．肝膿瘍の原因検索として，可及的早期の消化管検索が重要と考えられた．

S. Yanai | Seiki Imada | A. Kwon

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