腹腔交通を有する非対称性二重体(上腹体)の手術治験と問題点

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  • Successful Operation on a Case of Duplicates Asymmetros (EDierastrius) with Abdominal Communication
  • フククウ コウツウ オ ユウスル ヒタイショウセイ ニジュウタイ ジョウ フク

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A parasitic body with a arm and legs attached to the epigastric region of a male newborn at full-term birth. The autosite weighed 3,400g at birth. The Fallot complex and omphalocele in size of 7× 6 × 6 cm were found. Under the amniotic sac the parasitic bowel was seen. An Upper GI tract X-ray series, Ba enema, IVP, cystogram and angiography via umblical artery revealed no organ communication between the autosite and the parasitic body. Inorder to avoid the rupture of the omphalocele, contamination, clotting troubles by circulatory insufficiency and respiratory burden, the radical resection with primary repair of the omphalocele was performed en the 3rd day of birth. The parasite was successfully detached without leaving any tissue in the autosite body. The abdominal wall was primarily closed. The parasite weighed 380 g. The lower extremities were well developed on both sides, but the arm not well developed. The head, heart, thorax, vertebral column and an arm were defective The sagittal sections in series of the extirpated pelvis were examined microscopically. The parasite had the bladder, colon, sacrum, prostate, external genitalia without testicles and atretic anus. The testicles were found on the skin-edge of the resected arm. Both testicles were underdeveloped for his age. By these findings,"it was pointed out that the organs of the parasite which are left in the autosite at operation may have potential of neoplastic development the autosite. Reviewing the Japanese literatures, the authors found 13 cases of the Epigastrius. Seven case are still-biith and 6 operated. Five cases are alive, but only one of the abdominal communicatioi is alive. The association of omphalocle is found in high incidence.

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