遺伝子組換え型ヒトトロンボモジュリン製剤とPMX-DHPの併用療法が有効であった大腸癌急性汎発性腹膜炎の２例

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  • Two Cases of Panperitonitis due to Colon Cancer for Which a Therapy with both Human Soluble Thrombomodulin and Polymyxin B-Immobillized Fiber Column-Direct Hemoperfusion was Effective
  • イデンシ クミカエ ガタ ヒトトロンボモジュリン セイザイ ト PMX-DHP ノ ヘイヨウ リョウホウ ガ ユウコウ デ アッタ ダイチョウ ガン キュウセイ ハンハツセイ フクマクエン ノ 2レイ

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We experienced two cases of panperitonitis due to colon cancer for which a therapy both with human soluble thrombomodulin (rTM) and Polymyxin B-immobilized fiber column-direct hemoperfusion(PMX-DHP) was effective. An 80-year-old woman was referred to our hospital by ileus. Stoma at the transverse colon was made for obstruction of colon by rectal cancer. Intensive care was done for postoperative pre-DIC and ARDS. Sequential Organ Failure Assesment Score (SOFA score) improved from eight to two owing to effect of the combination therapy. Another 82-year-old woman was referred to our hospital as lower intestinal perforation was suspected. Abdominal CT examination revealed sigmoid colon perforation due to rectal cancer. We performed urgently recto-sigmoidectomy and stoma formation of sigmoid colon. Although she suffered from DIC after surgery, SOFA score improved from 11 to 7 by the combination therapy. It was thought that the combination therapy was effective for inflammatory DIC caused by acute panperitonitis by colon cancer.

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