Laparoscopic Surgery for Ileoceacal Abscess due to Crohn’s Disease Occurred to the Patient with Severe Motor and Intellectual Disabilities

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  • Terada Yoshitaka
    Division of Gastrointestinal, Breast and General Surgery, Department of Surgery, Shiga University of Medical Science
  • Sonoda Hiromichi
    Division of Gastrointestinal, Breast and General Surgery, Department of Surgery, Shiga University of Medical Science
  • Ueki Tomoyuki
    Division of Gastrointestinal, Breast and General Surgery, Department of Surgery, Shiga University of Medical Science
  • Miyake Toru
    Division of Gastrointestinal, Breast and General Surgery, Department of Surgery, Shiga University of Medical Science
  • Shimizu Tomoharu
    Division of Gastrointestinal, Breast and General Surgery, Department of Surgery, Shiga University of Medical Science
  • Tani Masaji
    Division of Gastrointestinal, Breast and General Surgery, Department of Surgery, Shiga University of Medical Science

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  • 心身障害者のCrohn病・回盲部膿瘍に腹腔鏡下回盲部切除術を行った１例

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Abstract

<p>We report herein a case of laparoscopic ileocecal resection for an ileocecal abscess due to Crohnʼs disease complicated with severe motor and intellectual disabilities. A 23-year-old woman was admitted to a nursing home because of cerebral palsy and mental retardation. Because of lack of activity from 1 month ago, she visited a nearby doctor. She was diagnosed with suspected intussusception and introduced to our hospital. At the time of admission, abdominal contrasted CT examination showed thickening of the wall from the terminal ileum to the ascending colon, and findings suspected of abscess formation in the ileal mesentery. Laparoscopic ileocecal resection was performed after infection control by conservative treatment for intraperitoneal abscess. Macroscopic findings of the excised specimen showed a longitudinal ulcer and fistulization, while histological findings revealed full thickness inflammation and epithelioid granuloma, resulting in a diagnosis of Crohnʼs disease. Early diagnosis of the intraperitoneal abscess was difficult because she was a patient with severe motor and intellectual disabilities who had difficulty communicating, and diagnosis findings were unclear. Laparoscopic surgery superior in minimally invasive and well-tolerable was possible by preceding infection control by conservative treatment.</p>

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