[A degreasing worker with pneumatosis cystoides intestinalis caused by trichloroethylene exposure].
نویسندگان
چکیده
3) 臨床経過 主訴:腹部膨満感,便通異常,粘液便. 既往歴:約30年間,心療内科に通院し抗精神病薬な どを服用している.その他に既往症はない. 現病歴:銅管の脱脂洗浄のため,2011年4月よりト リクロロエチレンを使用し始めたが,その2年半後の 2013年秋に便秘気味になり,その後,腹部膨満感があ り,ガスがよく出てトイレが近くなり,粘液も出るよう になった.同年12月に来院したため,腹部CT検査およ び超音波検査を実施した.その後も症状が続き,2014 年5月に来院したため,大腸内視鏡検査を実施した. 腹部CT検査:2013年12月の腹部CT検査では,上行 結腸に複数の憩室が認められた. 超音波検査:2013年12月の超音波検査では,強い腸 管内ガスエコーが認められた. 大腸内視鏡検査:2014年5月の大腸内視鏡検査では, 回盲部,上行結腸,S状結腸,上部直腸において多数の 粘膜下腫瘍様隆起が見られ(Fig. 1),腸管嚢腫様気腫 症(PCI)と診断した.その後,整腸剤(ミヤBM錠) を処方するとともに,トリクロロエチレンを扱う仕事 を中止するように指示した.同年8月の大腸内視鏡検査 では,上行結腸に粘膜下腫瘍様隆起があるものの,表 面の発赤は軽減し,緊満感も減少していることを確認 した.また,S状結腸は粘膜下腫瘍様隆起が残存してい るものの,ごくわずかであり,緊満感を持った粘膜下 気腫はほとんど消失していた(Fig. 1). 2014年 10月 16日受付;2014年 12月 25日受理 J-STAGE早期公開日:2015年 1月 14日
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ورودعنوان ژورنال:
- Sangyo eiseigaku zasshi = Journal of occupational health
دوره 57 2 شماره
صفحات -
تاریخ انتشار 2015