Segmental Dilatation of the Intestine : A case Presentation and Review of Literature

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  • Segmental Dilatation of the Intestine : 回腸部分拡張症の1治験例と文献的報告例の検討

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Segmental idiopathic dilatation of the intestine is a rare congenital abnormality. During past 33 years, 93 cases of segmental dilatation of the intestine have been reported in world literatures. We report a case of segmental dilatation of the ileum and the previous literature is reviewed. A 3-year-old boy with a history of intussusception that was reduced by barium enema at the age of 2 years old was admitted to the hospital with complaints of abdominal pain, nausea and vomiting. The barium meal and follow-through x-ray showed a dilated loop of the mid-ileum. With further passage of barium into the colon, a normal colon was ensured. The finding of a technecium-99m-pertechnetate scan was positive on the upper abdomen. At laparotomy a dilated segment of ileum located approximately 50cm from the ileocaecal valve and an intestinal malrotation were found. A resection of the dilated ileum was performed with end-to-end anastomosis and the intestinal malrotation was treated by Ladd procedure. An ulcer was present on the mucosa of the resected specimen. Microscopically the ganglion cells of the dilated ileum were normal and a heterotopic gastric mucosa was detected in the ileal mucosa. The patient's course was uneventful and he was discharged on the 13th postoperative day in a good condition. In published repors, the etiology of this disease is not clear yet but a segmental resection of dilated tract with end-to-end anastomosis is recommended to yield good results.

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