左側腹壁破裂の2例

一般的に腹壁破裂は臍帯の右側に開口し，左側腹壁破裂はまれである．症例1は女児．妊娠35週0日に帝王切開で出生．出生体重2,606 g．臍帯の左側に腹壁欠損孔あり．腸管外先天合併異常．日齢0にサイロ造設術，日齢10に腹壁閉鎖術を施行した．術後経過は良好で特記すべき合併症．症例2は男児．妊娠36週1日に帝王切開で出生．出生体重2,014 g．臍帯の左側に腹壁欠損孔あり．腸管外先天合併異常．日齢0にサイロ造設術，日齢6に腹壁閉鎖術を施行した．術後経過良好で臍ヘルニア以外に有意な合併症．左側腹壁破裂は女児に多く，腸管外先天合併異常を高率に合併する．腹壁閉鎖法は症例に応じ一期的もしくは多期的閉鎖が選択さ...

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Published in日本小児外科学会雑誌 Vol. 56; no. 3; pp. 302 - 308
Main Authors 竹内, 優太, 井上, 成一朗, 別宮, 好文, 小高, 明雄, 牟田, 裕紀
Format Journal Article
LanguageJapanese
Published 特定非営利活動法人 日本小児外科学会 20.06.2020
日本小児外科学会
Subjects
腹壁異常
腹壁破裂
臍帯
Online AccessGet full text
ISSN0288-609X
2187-4247
DOI10.11164/jjsps.56.3_302

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Abstract 一般的に腹壁破裂は臍帯の右側に開口し，左側腹壁破裂はまれである．症例1は女児．妊娠35週0日に帝王切開で出生．出生体重2,606 g．臍帯の左側に腹壁欠損孔あり．腸管外先天合併異常．日齢0にサイロ造設術，日齢10に腹壁閉鎖術を施行した．術後経過は良好で特記すべき合併症．症例2は男児．妊娠36週1日に帝王切開で出生．出生体重2,014 g．臍帯の左側に腹壁欠損孔あり．腸管外先天合併異常．日齢0にサイロ造設術，日齢6に腹壁閉鎖術を施行した．術後経過良好で臍ヘルニア以外に有意な合併症．左側腹壁破裂は女児に多く，腸管外先天合併異常を高率に合併する．腹壁閉鎖法は症例に応じ一期的もしくは多期的閉鎖が選択される．左側腹壁破裂そのものの予後は良好だが，腸管外先天合併異常に影響される．そのため，左側腹壁破裂の知識を有することは臨床上有用である．左側腹壁破裂の検討は腹壁破裂の発生機序解明の一助になると考えられる．
AbstractList 「要旨」一般的に腹壁破裂は臍帯の右側に開口し, 左側腹壁破裂はまれである. 症例1は女児. 妊娠35週0日に帝王切開で出生. 出生体重2,606g. 臍帯の左側に腹壁欠損孔あり. 腸管外先天合併異常なし. 日齢0にサイロ造設術, 日齢10に腹壁閉鎖術を施行した. 術後経過は良好で特記すべき合併症なし. 症例2は男児. 妊娠36週1日に帝王切開で出生. 出生体重2,014g. 臍帯の左側に腹壁欠損孔あり. 腸管外先天合併異常なし. 日齢0にサイロ造設術, 日齢6に腹壁閉鎖術を施行した. 術後経過良好で臍ヘルニア以外に有意な合併症なし. 左側腹壁破裂は女児に多く, 腸管外先天合併異常を高率に合併する. 腹壁閉鎖法は症例に応じ一期的もしくは多期的閉鎖が選択される. 左側腹壁破裂そのものの予後は良好だが, 腸管外先天合併異常に影響される. そのため, 左側腹壁破裂の知識を有することは臨床上有用である. 左側腹壁破裂の検討は腹壁破裂の発生機序解明の一助になると考えられる.
一般的に腹壁破裂は臍帯の右側に開口し，左側腹壁破裂はまれである．症例1は女児．妊娠35週0日に帝王切開で出生．出生体重2,606 g．臍帯の左側に腹壁欠損孔あり．腸管外先天合併異常．日齢0にサイロ造設術，日齢10に腹壁閉鎖術を施行した．術後経過は良好で特記すべき合併症．症例2は男児．妊娠36週1日に帝王切開で出生．出生体重2,014 g．臍帯の左側に腹壁欠損孔あり．腸管外先天合併異常．日齢0にサイロ造設術，日齢6に腹壁閉鎖術を施行した．術後経過良好で臍ヘルニア以外に有意な合併症．左側腹壁破裂は女児に多く，腸管外先天合併異常を高率に合併する．腹壁閉鎖法は症例に応じ一期的もしくは多期的閉鎖が選択される．左側腹壁破裂そのものの予後は良好だが，腸管外先天合併異常に影響される．そのため，左側腹壁破裂の知識を有することは臨床上有用である．左側腹壁破裂の検討は腹壁破裂の発生機序解明の一助になると考えられる．
Author 小高, 明雄
竹内, 優太
別宮, 好文
牟田, 裕紀
井上, 成一朗
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References 4) Moore TC: Gastroschisis and omphalocele: Clinical differences. Surgery, 82: 561-568, 1977.
14) Yoshioka H, Aoyama K, Iwamura Y, et al: Two cases of left-sided gastroschisis: Review of the literature. Pediatr Surg Int, 20: 472-473, 2004.
9) Thepcharoennirund S: Left-sided gastroschisis: Two case reports in Ratchaburi Hospital. J Med Assoc Thai, 83: 804-808, 2000.
36) Torfs CP, Christianson RE, Iovannisci DM, et al: Selected gene polymorphisms and their interaction with maternal smoking, as risk factors for gastroschisis. Birth Defects Res A Clin Mol Teratol, 76: 723-730, 2006.
15) Gow KW, Bhatia A, Saad DF, et al: Left-sided gastroschisis. Am Surg, 72: 637-640, 2006.
3) 黒田達夫，北野良博，森川信行，他：腹壁異常の長期フォローアップ．周産期医，40: 1251-1254, 2010.
16) Prasun P, Pradhan M, Kumari N, et al: Left-sided gastroschisis and bilateral multicystic dysplastic kidneys: A rare combination of anomalies. Prenat Diagn, 27: 872-873, 2007.
30) Feldkamp ML, Carey JC, Sadler TW: Development of gastroschisis: Review of hypotheses, a novel hypothesis, and implications for research. Am J Med Genet A, 143A: 639-652, 2007.
32) deVries PA: The pathogenesis of gastroschisis and omphalocele. J Pediatr Surg, 15: 245-251, 1980.
7) Hirthler MA, Goldthorn JF: A neonate having a left-sided gastroschisis. J Pediatr Surg, 24: 513, 1989.
34) Shaw A: The myth of gastroschisis. J Pediatr Surg, 10: 235-244, 1975.
26) Schierz IAM, Pinello G, Giuffrè M, et al: An unusual association of left-sided gastroschisis and persistent right umbilical vein. Clin Case Reports, 6: 2511-2512, 2018.
17) Punia RPS, Dhingra N, Chopra R, et al: A. Left-sided gastroschisis with meromelia of the limbs: A rare association. Congenit Anom (Kyoto), 49: 33-34, 2009.
6) Blair GK, Marshall RH: The abdominal wall defect “almost always” lies to the right of the umbilicus. J Pediatr Surg, 23: 989, 1988.
12) Orpen N, Mathievathaniy M, Hitchcock R: Left-sided gastroschisis and pseudoexstrophy: A rare combination of anomalies. Pediatr Surg Int, 20: 551-552, 2004.
18) Patel R, Eradi B, Ninan GK: Mirror image left-sided gastroschisis. ANZ J Surg, 80: 472-473, 2010.
23) Singh AP, Mathur V, Tanger R, et al: Left-sided gastroschisis with Meckel’s diverticulum: A rare presentation. J Neonatal Surg, 6: 70, 2017.
10) Pringle KC: Testicular proximity can induce gubernaculum formation after delivery. J Pediatr Surg, 36: 1708-1709, 2001.
1) Suver D, Lee SL, Shekherdimian S, et al: Left-sided gastroschisis: Higher incidence of extraintestinal congenital anomalies. Am J Surg, 195: 663-666, 2008.
5) 吉岡秀人，青山興司，岩村喜信，他：左側腹壁破裂の1例．小児外科，34: 344-346, 2002.
8) Tóth PP, Kimura K: Left-sided gastroschisis. J Pediatr Surg, 28: 1543-1544, 1993.
21) Patel RV, Sinha CK, More B, et al: Closing left gastroschisis with vanishing left testis. BMJ Case Rep, 2013: bcr2013200683, 2013.
28) Beaudoin S: Insights into the etiology and embryology of gastroschisis. Semin Pediatr Surg, 27: 283-288, 2018.
24) Rahul SK, Yadav R, Kumar V, et al: Left sided gastroschisis. J Neonatal Surg, 6: 53, 2017.
13) Wang KS, Skarsgard ED: Left-sided gastroschisis associated with situs inversus. J Pediatr Surg, 39: 1883-1884, 2004.
27) 大塩猛人，矢田清吾，大和秀夫，他：Vitelline vessel遺残を合併したGastroschisis 1治験例―Gastroschisisの病因に関する臨床的考察―．日小外会誌，19: 953-958, 1983.
35) Bargy F, Beaudoin S: Comprehensive developmental mechanisms in gastroschisis. Fetal Diagn Ther, 36: 223-230, 2014.
19) Shi Y, Farinelli CK, Chang MS, et al: Left-sided gastroschisis with placenta findings: Case report and literature review. Int J Clin Exp Pathol, 5: 243-246, 2012.
2) 日本小児外科学会学術委員会：腹壁異常アンケート調査結果報告．日小外会誌，34: 1213-1222, 1998.
33) 進藤潤一，長谷川潔，國土典宏：肝解剖をめぐるcontroversy右側肝円索≠左側胆囊．肝胆膵画像，13: 405-409, 2011.
31) Mandelia A: Aetiology of left-sided gastroschisis. Afr J Paediatr Surg, 12: 159, 2015.
11) Ashburn DA, Pranikoff T, Turner CS: Unusual presentations of gastroschisis. Am Surg, 68: 724-727, 2002.
29) Duhamel B: Embryology of exomphalos and allied malformations. Arch Dis Child, 38: 142-147, 1963.
25) Litman EA, Robinson TD, Munshi UK, et al: Left-sided gastroschisis: A case report and review of the literature. J Pediatr Surg Case Reports, 36: 50-53, 2018.
22) Hombalkar NN, Rafe A, Prakash GD: Left-sided gastroschisis with caecal agenesis: A rare case report. Afr J Paediatr Surg, 12: 74-75, 2015.
20) Mandelia A, Agarwala S, Sharma N, et al: Left-sided gastroschisis: A rare congenital anomaly. J Clin Diagn Res, 7: 2300-2302, 2013.
References_xml – reference: 7) Hirthler MA, Goldthorn JF: A neonate having a left-sided gastroschisis. J Pediatr Surg, 24: 513, 1989.
– reference: 21) Patel RV, Sinha CK, More B, et al: Closing left gastroschisis with vanishing left testis. BMJ Case Rep, 2013: bcr2013200683, 2013.
– reference: 25) Litman EA, Robinson TD, Munshi UK, et al: Left-sided gastroschisis: A case report and review of the literature. J Pediatr Surg Case Reports, 36: 50-53, 2018.
– reference: 16) Prasun P, Pradhan M, Kumari N, et al: Left-sided gastroschisis and bilateral multicystic dysplastic kidneys: A rare combination of anomalies. Prenat Diagn, 27: 872-873, 2007.
– reference: 23) Singh AP, Mathur V, Tanger R, et al: Left-sided gastroschisis with Meckel’s diverticulum: A rare presentation. J Neonatal Surg, 6: 70, 2017.
– reference: 3) 黒田達夫，北野良博，森川信行，他：腹壁異常の長期フォローアップ．周産期医，40: 1251-1254, 2010.
– reference: 19) Shi Y, Farinelli CK, Chang MS, et al: Left-sided gastroschisis with placenta findings: Case report and literature review. Int J Clin Exp Pathol, 5: 243-246, 2012.
– reference: 18) Patel R, Eradi B, Ninan GK: Mirror image left-sided gastroschisis. ANZ J Surg, 80: 472-473, 2010.
– reference: 27) 大塩猛人，矢田清吾，大和秀夫，他：Vitelline vessel遺残を合併したGastroschisis 1治験例―Gastroschisisの病因に関する臨床的考察―．日小外会誌，19: 953-958, 1983.
– reference: 26) Schierz IAM, Pinello G, Giuffrè M, et al: An unusual association of left-sided gastroschisis and persistent right umbilical vein. Clin Case Reports, 6: 2511-2512, 2018.
– reference: 22) Hombalkar NN, Rafe A, Prakash GD: Left-sided gastroschisis with caecal agenesis: A rare case report. Afr J Paediatr Surg, 12: 74-75, 2015.
– reference: 32) deVries PA: The pathogenesis of gastroschisis and omphalocele. J Pediatr Surg, 15: 245-251, 1980.
– reference: 8) Tóth PP, Kimura K: Left-sided gastroschisis. J Pediatr Surg, 28: 1543-1544, 1993.
– reference: 4) Moore TC: Gastroschisis and omphalocele: Clinical differences. Surgery, 82: 561-568, 1977.
– reference: 12) Orpen N, Mathievathaniy M, Hitchcock R: Left-sided gastroschisis and pseudoexstrophy: A rare combination of anomalies. Pediatr Surg Int, 20: 551-552, 2004.
– reference: 13) Wang KS, Skarsgard ED: Left-sided gastroschisis associated with situs inversus. J Pediatr Surg, 39: 1883-1884, 2004.
– reference: 17) Punia RPS, Dhingra N, Chopra R, et al: A. Left-sided gastroschisis with meromelia of the limbs: A rare association. Congenit Anom (Kyoto), 49: 33-34, 2009.
– reference: 9) Thepcharoennirund S: Left-sided gastroschisis: Two case reports in Ratchaburi Hospital. J Med Assoc Thai, 83: 804-808, 2000.
– reference: 30) Feldkamp ML, Carey JC, Sadler TW: Development of gastroschisis: Review of hypotheses, a novel hypothesis, and implications for research. Am J Med Genet A, 143A: 639-652, 2007.
– reference: 1) Suver D, Lee SL, Shekherdimian S, et al: Left-sided gastroschisis: Higher incidence of extraintestinal congenital anomalies. Am J Surg, 195: 663-666, 2008.
– reference: 15) Gow KW, Bhatia A, Saad DF, et al: Left-sided gastroschisis. Am Surg, 72: 637-640, 2006.
– reference: 34) Shaw A: The myth of gastroschisis. J Pediatr Surg, 10: 235-244, 1975.
– reference: 29) Duhamel B: Embryology of exomphalos and allied malformations. Arch Dis Child, 38: 142-147, 1963.
– reference: 31) Mandelia A: Aetiology of left-sided gastroschisis. Afr J Paediatr Surg, 12: 159, 2015.
– reference: 28) Beaudoin S: Insights into the etiology and embryology of gastroschisis. Semin Pediatr Surg, 27: 283-288, 2018.
– reference: 6) Blair GK, Marshall RH: The abdominal wall defect “almost always” lies to the right of the umbilicus. J Pediatr Surg, 23: 989, 1988.
– reference: 2) 日本小児外科学会学術委員会：腹壁異常アンケート調査結果報告．日小外会誌，34: 1213-1222, 1998.
– reference: 10) Pringle KC: Testicular proximity can induce gubernaculum formation after delivery. J Pediatr Surg, 36: 1708-1709, 2001.
– reference: 11) Ashburn DA, Pranikoff T, Turner CS: Unusual presentations of gastroschisis. Am Surg, 68: 724-727, 2002.
– reference: 5) 吉岡秀人，青山興司，岩村喜信，他：左側腹壁破裂の1例．小児外科，34: 344-346, 2002.
– reference: 14) Yoshioka H, Aoyama K, Iwamura Y, et al: Two cases of left-sided gastroschisis: Review of the literature. Pediatr Surg Int, 20: 472-473, 2004.
– reference: 33) 進藤潤一，長谷川潔，國土典宏：肝解剖をめぐるcontroversy右側肝円索≠左側胆囊．肝胆膵画像，13: 405-409, 2011.
– reference: 20) Mandelia A, Agarwala S, Sharma N, et al: Left-sided gastroschisis: A rare congenital anomaly. J Clin Diagn Res, 7: 2300-2302, 2013.
– reference: 35) Bargy F, Beaudoin S: Comprehensive developmental mechanisms in gastroschisis. Fetal Diagn Ther, 36: 223-230, 2014.
– reference: 36) Torfs CP, Christianson RE, Iovannisci DM, et al: Selected gene polymorphisms and their interaction with maternal smoking, as risk factors for gastroschisis. Birth Defects Res A Clin Mol Teratol, 76: 723-730, 2006.
– reference: 24) Rahul SK, Yadav R, Kumar V, et al: Left sided gastroschisis. J Neonatal Surg, 6: 53, 2017.
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Snippet 一般的に腹壁破裂は臍帯の右側に開口し，左側腹壁破裂はまれである．症例1は女児．妊娠35週0日に帝王切開で出生．出生体重2,606 g．臍帯の左側に腹壁欠損孔あり．腸管外先...
「要旨」一般的に腹壁破裂は臍帯の右側に開口し, 左側腹壁破裂はまれである. 症例1は女児. 妊娠35週0日に帝王切開で出生. 出生体重2,606g. 臍帯の左側に腹壁欠損孔あり. 腸...
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SubjectTerms 腹壁異常
腹壁破裂
臍帯
Title 左側腹壁破裂の2例
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ispartofPNX 日本小児外科学会雑誌, 2020/06/20, Vol.56(3), pp.302-308
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